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Sample records for neurologists neuroradiologists emergency

  1. Addressing life long learning needs of neurologist in the emerging world: a case study of an innovative CME program.

    Science.gov (United States)

    Sriharan, Abi

    2008-03-15

    What leadership roles can transnational medical professional societies play in addressing the life long learning needs of health professionals in emerging world? The World Federation of Neurology (WFN) provides neurological education programme in countries with unmet neurological training needs, in an effort to improve the knowledge and skills of neurologists. The WFN's experience provides a unique study to exemplify how global stakeholders collaborate with each other to deliver CME and to improve the quality of health care services. A multi-stage programme evaluation was undertaken to explore the WFN CME, in an effort to: a) understand how global CME programmes are organized, and b) understand the success factors and the challenges of delivering global CME. The programme evaluation was conducted between June 2005 and March 2006. The preliminary results were shared with the WFN education committee and national coordinators and international experts to check and confirm the findings from the study. The study results reveal that global CME programmes could be designed effectively with minimum costs. These programmes contribute to meeting the continued learning needs of neurologists in resource poor settings. Further, the WFN initiative provides, some initial evidence that these programs can contribute to systems level improvements.

  2. 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

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

    Science.gov (United States)

    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.

  4. The neurologist and patient safety.

    Science.gov (United States)

    Glick, Thomas H

    2005-05-01

    The objective of this article is to acquaint neurologists with the current status of evidence and opinion on patient safety in neurology. Research data on errors and preventable adverse events (harm from medical management) in neurology are sparse, with little light being cast thus far on the vulnerabilities of individual neurologists and neurologic office practices. However, areas of particular concern and lines of appropriate action are now becoming apparent. This review draws on the few studies of neurologic malpractice claims, inpatient incident reports and chart reviews, and articles and abstracts in the journal literature. These are placed in the context of the general epidemiology of medical errors, adverse events, and approaches to remediation. Accurate and timely diagnosis in all its aspects represents the single largest category of error. Most neurologists have their first interaction with a patient and family at the time of a critical illness, underlining the importance of improved communication, not only with them but with other caregivers. Systems of information transfer, such as those enabling timely imaging reports, are critical. Better consultative follow-up may be pivotal. Education in patient safety competencies and closer supervision of trainees can be expected to improve protection. Venues, such as emergency departments, in which relevant knowledge and skills may be insufficient to maximize patient safety, deserve particular attention.

  5. Factors influencing professional life satisfaction among neurologists

    National Research Council Canada - National Science Library

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

    2017-01-01

    .... Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice...

  6. Palliative care and the Indian neurologist.

    Science.gov (United States)

    Gursahani, Roop

    2016-10-01

    End-of-life care is an integral part of neurology practice, and neuropalliative medicine is an emerging neurology subspeciality. This begins with serious illness communication as a protocol-based process that depends on an evaluation of patient autonomy and accurate prognostication. Communication needs vary between chronic, life-limiting neurologic illnesses and acute brain injury. In an ideal situation, the patient's wishes are spelled out in advance care plans and living wills, and surrogates have only limited choices for implementation. Palliative care prepares for decline and death as an expected outcome and focuses on improving the quality of life for both the patients and their caregivers. In the Intensive Care Unit, this may require clarity on withholding and withdrawal of treatment. In all locations of care, the emphasis is on symptom control. Neurologists are the quintessential physicians, and our "dharma" is best served by empathetically bringing our technical knowledge and communication skills into easing this final transition for our patients and their families to the best of our ability.

  7. Palliative care and the Indian neurologist

    Directory of Open Access Journals (Sweden)

    Roop Gursahani

    2016-01-01

    Full Text Available End-of-life care is an integral part of neurology practice, and neuropalliative medicine is an emerging neurology subspeciality. This begins with serious illness communication as a protocol-based process that depends on an evaluation of patient autonomy and accurate prognostication. Communication needs vary between chronic, life-limiting neurologic illnesses and acute brain injury. In an ideal situation, the patient's wishes are spelled out in advance care plans and living wills, and surrogates have only limited choices for implementation. Palliative care prepares for decline and death as an expected outcome and focuses on improving the quality of life for both the patients and their caregivers. In the Intensive Care Unit, this may require clarity on withholding and withdrawal of treatment. In all locations of care, the emphasis is on symptom control. Neurologists are the quintessential physicians, and our “dharma” is best served by empathetically bringing our technical knowledge and communication skills into easing this final transition for our patients and their families to the best of our ability.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  10. Clinical research training of Peruvian neurologists: a baseline assessment

    Directory of Open Access Journals (Sweden)

    Joseph Raymond Zunt

    2010-06-01

    Full Text Available In Peru, despite a strong clinical research infrastructure in Lima, and Masters degree programs in epidemiology at three universities, few neurologists participate in clinical research. It was our objective to identify perceived needs and opportunities for increasing clinical research capacity and training opportunities for Peruvian neurologists. We conducted a descriptive, cross-sectional survey of Peruvian neurologists in Lima and Arequipa, Peru. Forty-eight neurologists completed written surveys and oral interviews. All neurologists reported interest in clinical research, but noted that lack of time and financial resources limited their ability to participate. Although most neurologists had received some training in epidemiology and research design as medical students or residents, the majority felt these topics were not adequately covered. Neurologists in Arequipa noted international funding for clinical research was uncommon outside the capital city of Lima. We concluded that clinical research is important to Peruvian neurologists. The three main barriers to increased participation in clinical research identified by neurologists were insufficient training in clinical research methodology, meager funding opportunities, and lack of dedicated time to participate in clinical research. Distance learning holds promise as a method for providing additional training in clinical research methodology, especially for neurologists who may have difficulty traveling to larger cities for additional training.

  11. Women neurologist: a worldwide and Brazilian struggle

    Directory of Open Access Journals (Sweden)

    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".

  12. Neurologists and the threat of bioterrorism.

    Science.gov (United States)

    Donaghy, Michael

    2006-11-01

    Neurologists are most likely to become involved in primarily diagnosing those bioterrorist attacks utilising botulinum toxin. Oral ingestion, or possibly inhalation, are likely routes of delivery. The characteristic descending paralysis starts in the extraocular and bulbar muscles, with associated autonomic features. Repetitive nerve stimulation usually shows an incremental muscle response. Treatment is supportive. The differential diagnosis is from naturally occurring paralysing illnesses such as Guillain-Barré syndrome, myasthenic crisis or diphtheria, from paralysing seafood neurotoxins (tetrodotoxin, saxitoxin), snake envenomation, and from chemical warfare poisoning by organophosphates. Primary neurological infections are less feasible for use as bioweapons. There are theoretical possibilities of Venezuelan equine encephalitis transmission by inhalation and secondary zoonotic transmission cycles sustained by horses and mosquitoes. Severe haemorrhagic meningitis regularly occurs in anthrax, usually in the aftermath of severe systemic disease likely to have been transmitted by spore inhalation. Panic and psychologically determined 'me-too' symptomatology are likely to pose the biggest diagnostic and management burden on neurologists handling bioterrorist attack on an institution or a random civilian population. Indeed civilian panic and disablement of institutional operations are likely to be prominent intentions of any bioterrorist attack.

  13. Law, ethics, and the clinical neurologist.

    Science.gov (United States)

    Nora, Lois Margaret

    2013-01-01

    There is dynamic interplay between the disciplines of law and ethics, and the result is often laws and regulation that impact the practice of clinical neurology. This chapter explores how the disciplines of law and ethics inform and intersect with each other, and how resulting law impacts the everyday work of the clinical neurologist. Examples of how the core bioethical principles of nonmaleficence, beneficence, respect for autonomy, and justice are manifest in legislative, common, and administrative laws are presented. Examples of how these laws, in turn, impact the practice of neurology through protection of patient privacy, the avoidance of conflict of interest, and informed consent and other issues are offered. © 2013 Elsevier B.V. All rights reserved.

  14. [Vertigo and dizziness: the neurologist's perspective].

    Science.gov (United States)

    Strupp, M

    2013-01-01

    The spectrum of diagnoses of patients with dizziness as the leading symptom who consult a neurologist does not differ greatly from the spectrum of those who consult ear nose and throat (ENT) specialists or general practitioners (GP). The most frequent forms are benign paroxysmal positioning vertigo (BPPV), phobic postural vertigo, central vertigo disorders, Menière's disease, vestibular neuritis and bilateral vestibulopathy. However, the first and most important question that is posed to neurologists is whether it is a central or peripheral syndrome. In more than 90 % of cases this differentiation is possible by taking the patient history (asking about the type of vertigo, the duration, triggers and accompanying symptoms) and conducting a physical examination of the patient. In the case of acute vertigo disorders in particular, a five-step procedure has proved to be helpful: the cover test to look for skew deviation as the central sign and component of the ocular tilt reaction, an examination with and without Frenzel's goggles to differentiate between peripheral vestibular spontaneous nystagmus and central fixation nystagmus, an examination of smooth pursuit and gaze-holding function and finally the head-impulse test to look for a deficit in the vestibulo-ocular reflex (VOR). Considerable advances have been made in the treatment of vertigo disorders in the last 10 years, e.g., cortisone for the treatment of acute vestibular neuritis, betahistine as a high-dosage, long-term treatment for Menière's disease, carbamazepine to treat vestibular paroxysmia and aminopyridine for downbeat nystagmus and episodic ataxia type 2.

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

    LENUS (Irish Health Repository)

    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.

  16. Practices of epilepsy during pregnancy: a survey of Canadian neurologists.

    Science.gov (United States)

    Morrison, C; Rieder, M J

    1993-01-01

    The optimal management of epilepsy in epileptic pregnancies remains controversial. We surveyed all neurologists in Canada to determine their usual practice in managing epilepsy during pregnancy. We identified 436 neurologists in the 1990 edition of the Canadian Handbook of Medical and Surgical Specialists. We mailed a questionnaire enquiring with respect to details of management of epilepsy during pregnancy to all neurologists; in the case of nonrespondents, a follow-up questionnaire was mailed eight weeks later. We achieved a 65% response rate. We found that carbamazepine was the antiepileptic drug of first choice for the management of epilepsy during pregnancy among the majority of neurologists (75%), while phenobarbital (10%) and phenytoin (11%) were recommended much less frequently. Eight percent of respondents never used polytherapy during pregnancy. Despite recent controversy over the reproductive safety of carbamazepine, monotherapy with carbamazepine is regarded by the vast majority of Canadian neurologists as the therapy of first choice for epilepsy during pregnancy.

  17. 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.

    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

    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.

  18. What the child neurologist should know about the visual system.

    Science.gov (United States)

    Rust, Robert S

    2011-06-01

    The visual system provides an important and highly sensitive opportunity to localize and diagnose neurological diseases. Within the context of the enormous sybject of neuro-ophthalmology there are fundamentals that should be known at the completion of training by the child neurologist. Upon the basis of this information the child neurologist may increase and refine sophistication through the course of an ensuing career. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Italian neurologists' perception on cognitive symptoms in major depressive disorder.

    Science.gov (United States)

    Neri, G; Serrati, C; Zolo, P; Cataldo, N; Ripellino, C

    2016-09-01

    The assessment of cognition is an important part of major depressive disorder (MDD) evaluation and a crucial issue is the physicians' perception of cognitive dysfunction in MDD that remains nowadays a little known matter. The present study aims at investigating the understanding of neurologists' perception about cognitive dysfunction in MDD. An on-line survey addressed to 85 Italian neurologists in the period between May and June 2015 was performed. The questionnaire comprised three sections: the first section collecting information on neurologists' socio-demographic profile, the second investigating cognitive symptoms relevance in relation with different aspects and the third one explicitly focusing on cognitive symptoms in MDD. Cognitive symptoms are considered most significant among DSM-5 symptoms to define the presence of a Major Depressive Episode in a MDD, to improve antidepressant therapy adherence, patients' functionality and concurrent neurological condition, once resolved. Furthermore, an incongruity came to light from this survey: the neurologists considered cognitive symptoms a not relevant aspect to choose the antidepressant treatment in comparison with the other DSM-5 symptoms on one side, but they declared the opposite in the third part of the questionnaire focused on cognitive symptoms. Cognitive symptoms appeared to be a relevant aspect in MDD and neurologists have a clear understanding of this issue. Nevertheless, the discrepancy between neurologists' perception on cognitive symptoms and the antidepressant treatment highlights the feeling of an unmet need that could be filled increasing the awareness of existing drugs with pro-cognitive effects.

  20. Experience matters: neurologists' perspectives on ALS patients' well-being.

    Science.gov (United States)

    Aho-Özhan, Helena E A; Böhm, Sarah; Keller, Jürgen; Dorst, Johannes; Uttner, Ingo; Ludolph, Albert C; Lulé, Dorothée

    2017-04-01

    Despite the fatal outcome and progressive loss of physical functioning in amyotrophic lateral sclerosis (ALS), many patients maintain contentment in life. It has been shown that non-professionals tend to underestimate the well-being of patients with ALS, but professionals' perspective is yet to be studied. In total, 105 neurologists with varying degrees of experience with ALS were included in an anonymous survey. They were asked to estimate the quality of life and depressiveness of ALS patients with artificial ventilation and nutrition. Physicians' estimations were compared with previously reported subjective ratings of ALS patients with life-prolonging measures. Neurologists with significant experience on ALS and palliative care were able to accurately estimate depressiveness and quality of life of ALS patients with life-prolonging measures. Less experienced neurologists' estimation differed more from patients' reports. Of all life-prolonging measures neurologists regarded invasive ventilation as the measure associated with lowest quality of life and highest depressiveness of the patients. Experienced neurologists as well as neurologists with experience in palliative care are able to better empathize with patients with a fatal illness such as ALS and support important decision processes.

  1. Apathy: a practical guide for neurologists.

    Science.gov (United States)

    Stanton, Biba R; Carson, Alan

    2016-02-01

    Apathy is an under-recognised and underestimated problem for people with chronic neurological disorders. Despite being common and disabling, it is seldom volunteered as a symptom by patients or even their caregivers. Yet apathy undoubtedly has an important impact on caregiver stress, functional disability and quality of life. A detailed clinical assessment can distinguish apathy from depression and allow clinicians to make practical suggestions to reduce the impact of symptoms on individual patients and their families. Pharmacological approaches to treatment include cholinesterase inhibitors, dopamine agonists and stimulants. CASE 1A 66-year-old man with progressive supranuclear palsy returned to clinic for review. His wife was upset and finding it difficult to cope. She described him as 'completely lazy', as he just sat in his chair all day watching television, even though he could still do things for himself. She felt that he could not be bothered to speak to her anymore because he was 'obsessed with TV'. He did not seem to engage with the visits to the grandchildren that she arranged. He said that he felt fine apart from the problems with his walking.The neurologist was confident that the patient was not depressed, and that the wife's concerns reflected the apathy that is often very pronounced in progressive supranuclear palsy. By explaining to the man's wife that these problems were due to his disease, their relationship improved and she felt more able to cope with caring for him. CASE 2A 75-year-old man attended clinic with his wife. She had worried about him for over a year, as he had become increasingly withdrawn. He used to enjoy going to the local pub but now stayed at home all day. He seemed less concerned about his personal appearance, about which he used to be meticulous. More recently, she had noticed that he had become forgetful. On examination, he had a mild episodic memory deficit but no impairments in other domains.He was diagnosed with mild

  2. Interobserver variability of seizure semiology between two neurologist and caregivers.

    Science.gov (United States)

    Benbir, Gulcin; Demiray, Derya Yavuz; Delil, Sakir; Yeni, Naz

    2013-09-01

    We aimed to compare the extent of inter-observer variability in the description of seizure semiology between both neurologists and caregivers. We prospectively investigated 93 consecutive patients monitored over the past 5 years in our video-EEG unit. The videotaped seizures of the patients were reviewed independently by two neurologists who were blind to the clinical data. The questionnaires were completed by neurologists and caregivers. Interobserver rate of agreement between neurologists and caregivers was analyzed by using the kappa analysis and intraclass correlation coefficients. There was excellent agreement for questions regarding whether the patient's eyes remained open, laterality of head deviation, arm movements, and ictal period. On the other hand, interobserver rate of agreement was fair to moderate for the laterality of hand automatisms, the presence of nose-wiping, and oral clonic jerks. Besides variability in interobserver agreement among clinicians, the variability or concordance between physicians and caregivers are also of great importance, especially in case of epilepsy, where the accurate description of the attacks is the major determinant of an accurate diagnosis. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Neurologists for patient safety: where we stand, time to deliver.

    Science.gov (United States)

    Glick, Thomas H; Rizzo, Matthew; Stern, Barney J; Feinberg, Daniel M

    2006-12-26

    Neurologists have a professional opportunity, an ethical responsibility, and sound clinical and economic reasons for engaging in efforts to improve patient safety. Better communication with patients and other providers, closer follow-up of consultation cases, and more focused supervision of trainees will help to reduce current patterns of error and misunderstanding. Patient education with attention to health literacy should improve adherence to management plans and help to bridge transitions of care across providers and sites. Through teaching and by example, neurologists can profoundly influence successive generations of clinicians to adopt safer practices, a culture of openness, and enhanced professionalism. The federal Safety and Quality Improvement Act of 2005, once implemented, should increase the evidence basis for safer care through voluntary, legally protected reporting of errors and adverse events within the framework of patient safety organizations.

  4. Opinion & Special Articles: neurologist: specialized primary care provider vs consultant.

    Science.gov (United States)

    Lakhan, Shaheen E; Schwindt, Mitchel; Alshareef, Bashar N; Tepper, Deborah; Mays, Maryann

    2013-07-02

    As per the Centers for Medicare and Medicaid Services (CMS) current proposal, many specialties including neurology are not eligible for the increase in Medicare reimbursements that will be allocated to other cognitive specialties, such as the 7% increase for family physicians, 5% for internists, and 4% for geriatric specialists.(1,2) Other specialties such as anesthesiology, radiology, and cardiology are scheduled for a 3%-4% decrease in reimbursement in order to pay for the increases outlined above. Current estimates show that neurologists provide a significant amount of primary care for complex patients and yet these services are not eligible for increased payments. It is estimated that up to 60% of neurologists' services to these complex patients are ineligible for increased payments.(3.)

  5. Yield of emergent neuroimaging in children with new-onset seizure and status epilepticus.

    Science.gov (United States)

    Lyons, Todd W; Johnson, Kara B; Michelson, Kenneth A; Nigrovic, Lise E; Loddenkemper, Tobias; Prabhu, Sanjay P; Kimia, Amir A

    2016-02-01

    To determine the yield of emergent neuroimaging among children with new-onset seizures presenting with status epilepticus. We performed a cross-sectional study of children seen at a single ED between 1995 and 2012 with new-onset seizure presenting with status epilepticus. We defined status epilepticus as a single seizure or multiple seizures without regaining consciousness lasting 30 min or longer. Our primary outcome was urgent or emergent intracranial pathology identified on neuroimaging. We categorized neuroimaging results as emergent if they would have changed acute management as assessed by a blinded neuroradiologist and neurologist. To ensure abnormalities were not missed, we review neuroimaging results for 30 days following the initial episode of SE. We included 177 children presenting with new-onset seizure with status epilepticus, of whom 170 (96%) had neuroimaging performed. Abnormal findings were identified on neuroimaging in 64/177 (36%, 95% confidence interval 29-43%) children with 15 (8.5%, 95% confidence interval 5.2-14%) children having urgent or emergent pathology. Four (27%) of the 15 children with urgent or emergent findings had a normal non-contrast computed tomography scan and a subsequently abnormal magnetic resonance image. Longer seizure duration and older age were associated with urgent or emergent intracranial pathology. A substantial minority of children with new-onset seizures presenting with status epilepticus have urgent or emergent intracranial pathology identified on neuroimaging. Clinicians should strongly consider emergent neuroimaging in these children. Magnetic resonance imaging is the preferred imaging modality when available and safe. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  6. [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

  7. 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

  8. 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

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

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    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.

  10. 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.

  11. In-Vivo proton magnetic resonance spectroscopy of 2-Hydroxyglutarate in isocitrate dehydrogenase-mutated gliomas: A technical review for neuroradiologists

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    Kim, Hyeon Jin; Kim, Sung Jin [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Hyeong Hun; Heo, Hwon [Dept. of Biomedical Sciences, Seoul National University, Seoul (Korea, Republic of)

    2016-09-15

    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, were view previous in vivo studies, and discuss the current status of 1H-MRS in the diagnosis of IDH-MT gliomas.

  12. 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.

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

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    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

  14. Oliver Sacks--a neurologist explores the lifeworld.

    Science.gov (United States)

    Mergenthaler, D

    2000-01-01

    The neurologist Oliver Sacks has become very famous for his writings. His popularity has scattered all mass medias. In his books, he eloquently tells stories about patients suffering from extraordinary neurological diseases. Since the conceptual framework of Sacks' narratives has been widely unconsidered, this article pursues a more general and systematic approach to his work. Sacks terms his idiographic and phenomenological access to the world of science Romantical Science. With its features, he develops a concept of a Neurology of Identity, that is basically concerned with the patient's personality and subjectivity. Sacks' personal approach to medicine implies another understanding of diseases: For him, diseases cannot be reduced to pathological facts, they constitute other worlds. He characteristically uses philosophical, psychological and mythical terms for interpretation and narration. But conversely to its sympathetic appearance, Sacks' approach entails some deficits: His presentation is not always realistic, his interpretations are often one-sided. The theoretical reflections on his method and attitude remain poor. Nevertheless, he puts medicine back into lifeworld, to open it for many discourse universes beyond science in practice and theoretical reflection.

  15. [Favorable and effective instructional design (ID) for the future neurologist].

    Science.gov (United States)

    Doyu, Manabu

    2010-11-01

    Recently, there have been many drastic changes in the educational technology for the medical fields in Japan. The educational style has shifted from the classical, which weighs knowledge, to the American, which weighs skill or performance. These trends would come from theoretical transition in pedagogics, bringing out the tremendous progress in the instructional designs, which effectively facilitated the information and communication technology (ICT). On the contrary, Neurology, as a pedagogic, is more characteristic both in the quality and the quantity of knowledge, rather than skill or performance. It has resulted in occurring many discrepancies among the educational parts of Neurology, that may be one of reasons for medical students or postgraduate trainees, having been growing up in full of ICT, had some against images of difficulty in learning this subject. So it might be more necessary for us that we should hurry to create the authentic context in the educational design of Neurology, then construct the stepwise off-the-job training system honestly along with it, on which we should aim to increase familiarity of learning neurological diseases or skills for these younger people, the future neurologists. And the important tip is that we can utilize "games", the products of ICT, without any hesitation.

  16. 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.

  17. Clinical Identification of Dysarthria Types among Neurologists, Residents in Neurology and Speech Therapists

    NARCIS (Netherlands)

    van der Graaff, M.; Kuiper, T.; Zwinderman, A.; van de Warrenburg, B.; Poels, P.; Offeringa, A.; van der Kooi, A.; Speelman, H.; de Visser, M.

    2009-01-01

    Background: Classification of dysarthria types comprises flaccid, spastic, ataxic, hypo- and hyperkinetic and mixed dysarthria. This study focussed on the ability of neurologists to clinically identify the correct type of dysarthria in neurological patients. Methods: Eighteen patients with

  18. Clinical identification of dysarthria types among neurologists, residents in neurology and speech therapists.

    NARCIS (Netherlands)

    Graaff, M. Van der; Kuiper, T.; Zwinderman, A.; Warrenburg, B.P.C. van de; Poels, P.J.E.; Offeringa, A.; Kooi, A. van der; Speelman, H.D.; Visser, M. de

    2009-01-01

    BACKGROUND: Classification of dysarthria types comprises flaccid, spastic, ataxic, hypo- and hyperkinetic and mixed dysarthria. This study focussed on the ability of neurologists to clinically identify the correct type of dysarthria in neurological patients. METHODS: Eighteen patients with

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Patient expression of emotions and neurologist responses in first multiple sclerosis consultations.

    Science.gov (United States)

    Del Piccolo, Lidia; Pietrolongo, Erika; Radice, Davide; Tortorella, Carla; Confalonieri, Paolo; Pugliatti, Maura; Lugaresi, Alessandra; Giordano, Andrea; Heesen, Christoph; Solari, Alessandra

    2015-01-01

    Anxiety and depression are common in people with multiple sclerosis (MS), but data on emotional communication during MS consultations are lacking. We assessed patient expressions of emotion and neurologist responses during first-ever MS consultations using the Verona Coding Definitions of Emotional Sequences (VR-CoDES). We applied VR-CoDES to recordings/transcripts of 88 outpatient consultations (10 neurologists, four MS Italian centers). Before consultation, patients completed the Hospital Anxiety and Depression Scale (HADS). Multilevel sequential analysis was performed on the number of cues/concerns expressed by patients, and the proportion of reduce space responses by neurologists. Patients expressed 492 cues and 45 concerns (median 4 cues and 1 concern per consultation). The commonest cues were verbal hints of hidden worries (cue type b, 41%) and references to stressful life events (type d, 26%). Variables independently associated with number of cues/concerns were: anxiety (HADS-Anxiety score >8) (incidence risk ratio, IRR 1.08, 95% CI 1.06-1.09; pemotions by reducing space (changing subject, taking no notice, giving medical advice) for 58% of cues and 76% of concerns. Anxiety was the only variable significantly associated with 'reduce space' responses (odds ratio 2.17, 95% CI 1.32-3.57; p=0.003). Patient emotional expressions varied widely, but VR-CoDES cues b and d were expressed most often. Patient anxiety was directly associated with emotional expressions; older age of patients and neurologists, and second opinion consultations were inversely associated with patient emotional expression. In over 50% of instances, neurologists responded to these expressions by reducing space, more so in anxious patients. These findings suggest that neurologists need to improve their skills in dealing with patient emotions.

  4. 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.

  5. Patient expression of emotions and neurologist responses in first multiple sclerosis consultations.

    Directory of Open Access Journals (Sweden)

    Lidia Del Piccolo

    Full Text Available Anxiety and depression are common in people with multiple sclerosis (MS, but data on emotional communication during MS consultations are lacking. We assessed patient expressions of emotion and neurologist responses during first-ever MS consultations using the Verona Coding Definitions of Emotional Sequences (VR-CoDES.We applied VR-CoDES to recordings/transcripts of 88 outpatient consultations (10 neurologists, four MS Italian centers. Before consultation, patients completed the Hospital Anxiety and Depression Scale (HADS. Multilevel sequential analysis was performed on the number of cues/concerns expressed by patients, and the proportion of reduce space responses by neurologists.Patients expressed 492 cues and 45 concerns (median 4 cues and 1 concern per consultation. The commonest cues were verbal hints of hidden worries (cue type b, 41% and references to stressful life events (type d, 26%. Variables independently associated with number of cues/concerns were: anxiety (HADS-Anxiety score >8 (incidence risk ratio, IRR 1.08, 95% CI 1.06-1.09; p<0.001; patient age (IRR 0.98, 95% CI 0.98-0.99; p<0.001; neurologist age (IRR 0.94, 95% CI 0.92-0.96; p=0.03; and second opinion consultation (IRR 0.72, 95% CI 0.60-0.86; p=0.007. Neurologists reacted to patient emotions by reducing space (changing subject, taking no notice, giving medical advice for 58% of cues and 76% of concerns. Anxiety was the only variable significantly associated with 'reduce space' responses (odds ratio 2.17, 95% CI 1.32-3.57; p=0.003.Patient emotional expressions varied widely, but VR-CoDES cues b and d were expressed most often. Patient anxiety was directly associated with emotional expressions; older age of patients and neurologists, and second opinion consultations were inversely associated with patient emotional expression. In over 50% of instances, neurologists responded to these expressions by reducing space, more so in anxious patients. These findings suggest that

  6. Discussing sexuality with patients with Parkinson's disease : A survey among Dutch neurologists

    NARCIS (Netherlands)

    van Hees, P.J.; van der Plas, A.A.; van Ek, G.F.; Putter, H.; den Oudsten, B.L.; den Ouden, M.E.; Elzevier, H.W.

    2017-01-01

    Sexual functioning is often impaired in patients with Parkinson’s disease (PD) and may affect quality of life of patients and their spouse. However, little is known about the practice patterns of neurologists with regard to discussing sexuality in this field. The aim of this cross-sectional study

  7. Using a virtual training program to train community neurologist on EEG reading skills.

    Science.gov (United States)

    Ochoa, Juan; Naritoku, Dean K

    2012-01-01

    EEG training requires iterative exposure of different patterns with continuous feedback from the instructor. This training is traditionally acquired through a traditional fellowship program, but only 28% of neurologists in training plan to do a fellowship in EEG. The purpose of this study was to determine the value of online EEG training to improve EEG knowledge among general neurologists. The participants were general neurologists invited through bulk e-mail and paid a fee to enroll in the virtual EEG program. A 40-question pretest exam was performed before training. The training included 4 online learning units about basic EEG principles and 40 online clinical EEG tutorials. In addition there were weekly live teleconferences for Q&A sessions. At the end of the program, the participants were asked to complete a posttest exam. Fifteen of 20 participants successfully completed the program and took both the pre- and posttest exams. All the subjects scored significantly higher in the posttest compared to their baseline score. The average score in the pretest evaluation was 61.7% and the posttest average was 87.8% (p = .0002, two-tailed). Virtual EEG training can improve EEG knowledge among community neurologists.

  8. Evaluations of Neurologists by Their Patients and Residents Are Inversely Correlated

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    Michael R Dobbs MD, MHCM

    2016-03-01

    Full Text Available Objective and Background: We hypothesized that evaluation scores for attending neurologists by patients and residents would parallel one another. Additionally, we hypothesized that provider productivity would be also be associated with performance evaluations by patients and residents. Methods: In a university neurology department, we collected individual Clinician and Group Consumer Assessment of Healthcare Providers and Systems patient satisfaction scores and standardized resident evaluation scores (n = 22 faculty members. We performed bivariate analysis of doctor–patient satisfaction versus resident evaluation scores. Results: Attending neurologists with higher patient satisfaction received lower resident evaluation scores (P < .05. There seem to be disproportionate neurologists with low evaluations not meeting clinical productivity targets. Conclusion: Finding a significant inverse correlation was surprising. Perhaps what is valued by patients in their physician is not what residents value in teachers. That deserves further study. Maybe attending physicians who spend their energy on the patient experience do not have sufficient time to devote to teaching and vice versa. That neurologists with low evaluation scores appear more likely to not meet productivity targets supports this idea.

  9. Physician assisted suicide--the perspective of a neurologist.

    Science.gov (United States)

    Singh, S; Sardana, V; Prasad, K; Behari, M

    2001-08-01

    Modern medicine has resulted in a better control and treatment of many diseases. This has provided a better life for patients with treatable disorders, but at the same times has prolonged the suffering of the patients with diseases that are not treatable. This is of particular importance for the patients with neurological diseases, as some of these conditions have a relentlessly progressive course and cause significant distress to the patient. Recent times have seen an expansion of the scope of the various "rights of the patient" and according to some, this includes the "right to die". As a result of this concept of regarding the autonomy of the patient, the phenomenon of physician assisted suicide has emerged and is a topic of intense debate amongst the physicians, social workers and politicians all over the world. The present article puts forth the current concepts and brings out the exact definitions of the terms like physician-assisted suicide, voluntary active euthanasia and voluntary passive euthanasia. It presents the statements made by the various societies and organisations regarding the PAS. It also brings forth the point of view of the authors about this aspect of medicine. The authors share the view of the various scientific organisations, and opine that though the idea of physician assisted suicide may be morally justifiable in certain circumstances, it should not be made legal.

  10. 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.

  11. 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.

  12. Comparison of clinical gait analysis strategies by French neurologists, physiatrists and physiotherapists.

    Science.gov (United States)

    Watelain, Eric; Froger, Jérôme; Barbier, Franck; Lensel, Ghislaine; Rousseaux, Marc; Lepoutre, François-Xavier; Thevenon, André

    2003-01-01

    Clinical and functional gait analysis is used widely by different professionals dealing with patients with hemiplegia. The aim of this study was to examine the gait analysis strategies of neurologists, specialists in physical and rehabilitation medicine (physiatrists) and physiotherapists. Differences in global analysis strategy and choice of indicators between different clinicians have not previously been studied precisely, and we believe that a standardized approach would enhance the training of young practitioners. The knowledge acquisition phase (specialists' expertise identification) was completed by an identified expert with a subject groups of 5 neurologists, 5 specialists in physical and rehabilitation medicine and 5 physiotherapists, who were asked to comment on a videotape of patients with hemiplegia walking, followed by a semi-directed interview. The results show that specialists use a wide variety of gait indicators. The total number of different medical vocabulary and expressions used to describe gait was 396, semantically grouped as 60 general indicators. Specialists highlighted an analysis strategy (order, type and number of indicators) typical to each professional specialty. The neurologists tried to identify the elements allowing localization of lesions and characterized the hemiplegia globally,while the specialists in physical and rehabilitation medicine conducted a bio-mechanical analysis and the physiotherapists were highly descriptive. The differences in strategies adopted by each specialty contribute to an enrichment of gait analysis. This should be taken into account in teaching and determining gait assessment scales.

  13. Assessment of neurologists' knowledge regarding intravenous fibrinolytic therapy for acute stroke in Shanxi province in China.

    Science.gov (United States)

    Ma, Liansheng; Niu, Xiaoyuan; Zhang, Wei; Fang, Yalan; Wang, Jie

    2017-05-18

    Limitations in physicians' knowledge regarding fibrinolytic therapy for acute ischemic stroke may contribute to low rate of fibrinolytic therapy in China. Here physicians' knowledge was surveyed on intravenous fibrinolytic therapy for acute ischemic stroke. Neurologists (n = 175) from 27 major general hospitals in Shanxi province, P. R. China, were invited to complete questionnaires regarding their basic knowledge of intravenous fibrinolytic therapy for acute ischemic stroke. The questionnaire contained 12 multiple-choice questions. One point was assigned for a correct answer and zero point for a false or unanswered question. One hundred and thirty-one neurologists (74.9%) responded to the questionnaires. The mean accuracy rate of 12 questions was 54.9 ± 25.01% (range 0.8-96.2%). The mean total score for respondents was 6.59 ± 2.03 (range 2-11). More years of experience and higher academic degrees were independent factors related to the total scores (P = 0.000 and P = 0.004, respectively). The neurologists in this study were knowledge deficient in the area of intravenous fibrinolytic therapy for acute ischemic stroke. This partially accounts for the low rate of fibrinolytic therapy in China.

  14. Consensus on the Definition of Advanced Parkinson's Disease: A Neurologists-Based Delphi Study (CEPA Study)

    Science.gov (United States)

    Kulisevsky, Jaime; Tolosa, Eduardo S.

    2017-01-01

    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. PMID:28239501

  15. The European Board of Neurology Examination--junior neurologists are eager to take the challenge.

    Science.gov (United States)

    Struhal, W; Rakusa, M; Grisold, W; Sellner, J

    2011-08-01

      The Union Européenne des Médecins Spécialistes Section of Neurology (UEMS SEN)/European Board of Neurology (EBN) examination was launched in 2009 to set standards in knowledge and skills for the next generation of European neurologists.   Stimulated by the low participation at the first examination, we conducted a survey amongst 76 junior colleagues to assess awareness, motivation and obstacles regarding this examination.   Remarkably, junior neurologists indicated great interest in the examination and motivation to spend additional preparation time (up to 6months) with the aim to catch up with European standards and improve the care of patients. However, there are major issues, which detain our colleagues from taking the examination including the amount of the examination fee, the potential lack of language abilities and the varying usage of the recommended books for preparation.   This survey highlights the positive attitude of junior neurologists regarding initiatives to improve clinical skills and knowledge. Moreover, this study delineated several factors, which may be considered in the future to increase participation and substantiate the significance of the examination. © 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

  16. How Dutch neurologists involve families of critically ill patients in end-of-life care and decision-making

    NARCIS (Netherlands)

    Seeber, A.A.; Pols, A.J.; Hijdra, A.; Willems, D.L.

    When critically ill neurologic patients are cognitively incapacitated, decisions about treatment options are delegated to surrogates, usually family members. We conducted qualitative interviews with 20 Dutch neurologists and residents in neurology varying in age, work experience, and workplace to

  17. Neurologist consistency in interpreting information provided by an interactive visualization software for deep brain stimulation postoperative programming assistance.

    Science.gov (United States)

    Pallavaram, Srivatsan; Phibbs, Fenna T; Tolleson, Christopher; Davis, Thomas L; Fang, John; Hedera, Peter; Li, Rui; Koyama, Tatsuki; Dawant, Benoit M; D'Haese, Pierre-François

    2014-01-01

    Postoperative programming in deep brain stimulation (DBS) therapy for movement disorders can be challenging and time consuming. Providing the neurologist with tools to visualize the electrode location relative to the patient's anatomy along with models of tissue activation and statistical data can therefore be very helpful. In this study, we evaluate the consistency between neurologists in interpreting and using such information provided by our DBS programming assistance software. Five neurologists experienced in DBS programming were each given a dataset of 29 leads implanted in 17 patients. For each patient, probabilistic maps of stimulation response, anatomical images, models of tissue activation volumes, and electrode positions were presented inside a software framework called CRAnialVault Explorer (CRAVE) developed in house. Consistency between neurologists in optimal contact selection using the software was measured. With only the efficacy map, the average consistency among the five neurologists with respect to the mode and mean of their selections was 97% and 95%, respectively, while these numbers were 93% and 89%, respectively, when both efficacy and an adverse effect map were used simultaneously. Fleiss' kappa statistic also showed very strong agreement among the neurologists (0.87 when using one map and 0.72 when using two maps). Our five neurologists demonstrated high consistency in interpreting information provided by the CRAVE interactive visualization software for DBS postoperative programming assistance. Three of our five neurologists had no prior experience with the software, which suggests that the software has a short learning curve and contact selection is not dependent on familiarity with the program tools. © 2013 Vanderbilt University.

  18. 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.

  19. [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.

  20. Quality of Life Assessment in Multiple Sclerosis: Different Perception between Patients and Neurologists

    Directory of Open Access Journals (Sweden)

    Maria C. Ysrraelit

    2018-01-01

    Full Text Available BackgroundIn recent years, neurologists are noticing that evaluation of multiple sclerosis (MS patients based on combining relapses, disability progression, and magnetic resonance imaging activity may be insufficient to adequately assess suboptimal responses to available therapy. Inclusion of quality of life (QoL parameters may contribute to breach this gap.ObjectiveTo evaluate agreement levels between doctor and patient perception of QoL in MS.MethodsA total of 700 MS patients and 300 neurologists were invited to participate in a cross-sectional study by answering an e-mail questionnaire. The survey collected information on demographical data and included the Short Form questionnaire (SF-36. After completing the questionnaire, patients were given a standard written description of each of the subdomains assessed by SF-36 and asked to identify which three were the most important determinants of their overall health-related QoL.ResultsA total of 135 neurologists and 380 MS patients responded the survey. Study population mean age was 42.1 ± 10.5 years, with 61% presenting relapsing-remitting MS. SF-36 results were physical function 68.4 ± 30, physical role limitation 56.8 ± 41.7, vitality 47.6 ± 21.4, pain 71.2 ± 26.1, social function 72.6 ± 28.6, emotional role limitation 63.2 ± 39.8, mental health 60 ± 14.1, and general health 55.8 ± 22. Doctors considered physical function (75% and physical role limitation (70% as the most important QoL determinants in MS, followed by emotional role limitation (52%. Patients however, assigned significantly different levels of importance to physical function (58%, and physical role limitation (46% and considered vitality (52% more important than their physicians (p < 0.001. Important to note, the results of SF-36 questionnaire were highly correlated with the perception gap between patients and neurologists (r = 0.89; p = 0.0004.ConclusionConcerns on Qo

  1. 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.

  2. 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

  3. Duchenne, Charcot and Babinski, three neurologists of La Salpetrière Hospital, and their contribution to concepts of the central organization of motor synergy.

    Science.gov (United States)

    Clarac, François; Massion, Jean; Smith, Allan M

    2009-11-01

    Many currently accepted notions of motor control originate from a few seminal concepts developed in the latter half of the 19th century (see Bennett and Hacker, 2002). The goal of this review is to retrace some current ideas about motor control back to the thought of three French neurologists of Hospital of the Salpetrière hospital in Paris during the latter half of the 19th century and early 20th century (Fig. 1): Guillaume Duchenne de Boulogne (1806-1875), Jean-Martin Charcot (1825-1893), and Joseph Babinski (1857-1932). A common theoretical and methodological thread unites these three men as Charcot was taught neurology by Duchenne, and Babinski was trained by Charcot. The influential concepts developed by these pioneering French neurologists have been neglected for nearly a century and only rediscovered recently. We intend to highlight how these astute clinicians used their meticulous clinical observations of patients to reveal novel and original perspectives of motor co-ordination. Between 1850 and 1930, all three men played a major role in developing and shaping the entire field of normal and pathological motor control in addition to making important contributions to three major scientific issues; the centralist view of muscle sense, the emerging concept of muscle synergy in voluntary movements and in locomotion and finally the specific role of the cerebellum in muscle synergy. The important contributions of these men will be considered in the context of other significant schools of neurology from other countries. Finally, the concept of cerebellar asynergy as proposed by Babinski anticipated the development of the internal models which much later were able to provide a theoretical basis for understanding the mechanism of learned motor co-ordination involving the cerebellum.

  4. A survey of American neurologists about brain death: understanding the conceptual basis and diagnostic tests for brain death.

    Science.gov (United States)

    Joffe, Ari R; Anton, Natalie R; Duff, Jonathan P; Decaen, Allan

    2012-02-17

    Neurologists often diagnose brain death (BD) and explain BD to families in the intensive care unit. This study was designed to determine whether neurologists agree with the standard concept of death (irreversible loss of integrative unity of the organism) and understand the state of the brain when BD is diagnosed. A previously validated survey was mailed to a random sample of 500 board-certified neurologists in the United States. Main outcomes were: responses indicating the concept of death that BD fulfills and the empirical state of the brain that would rule out BD. After the second mailing, 218 (44%) surveys were returned. Few (n = 52, 27%; 95% confidence interval (CI), 21%, 34%) responded that BD is death because the organism has lost integrative unity. The most common justification was a higher brain concept (n = 93, 48%; 95% CI, 41%, 55%), suggesting that irreversible loss of consciousness is death. Contrary to the recent President's Council on Bioethics, few (n = 22, 12%; 95% CI, 8%, 17%) responded that the irreversible lack of vital work of an organism is a concept of death that the BD criterion may satisfy. Many responded that certain brain functions remaining are not compatible with a diagnosis of BD, including EEG activity, evoked potential activity, and hypothalamic neuroendocrine function. Many also responded that brain blood flow and lack of brainstem destruction are not compatible with a diagnosis of BD. American neurologists do not have a consistent rationale for accepting BD as death, nor a clear understanding of diagnostic tests for BD.

  5. Neurologist's contribution to the diagnosis of sine materia respiratory insufficiency: case report”

    Directory of Open Access Journals (Sweden)

    Carbonelli Cristiano

    2012-08-01

    Full Text Available Abstract Background Right-to-left shunt (RLS may be the cause of marked hypoxemia, a respiratory insufficiency which is usually difficult to diagnose by respiratory physicians as it develops in the absence of an intrinsic lung disease. Case presentation We report a case of RLS in a patient with a hepatopulmonary syndrome caused by chronic autoimmune cholangitis. RLS was suspected clinically by physical examination and by standard CT imaging and MIP reconstruction of the pulmonary vascular bed. Repeated previous transthoracic echocardiography (TTE studies did not reveal shunts or any cardiac defect. The final diagnosis was made by means of a minimally invasive transcranial Doppler examination with the use of saline agitated with 0.5 ml of patient’s blood as contrast solution. Conclusions Transcranial Colour-Coded Duplex Sonography (TCCS with saline contrast medium injection is described to have a higher sensitivity than TTE and comparable to transesophageal echocardiography (TEE in RLS diagnosis. The collaboration of neurologists in diagnosing respiratory insufficiency is very important as the examination is simple, well tolerated in comparison with the discomfort associated with transesophageal echocardiography, and minimally invasive in comparison with angiography, which is the last diagnostic procedure in this clinical scenario. In order to confirm RLS, TCCS with blood-saline contrast medium injection should be performed for the diagnosis of chronic hypoxemia for which causes are not detected with routine clinical examinations.

  6. [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.

  7. 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.

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

    Science.gov (United States)

    Kinsella, Justin A; Tobin, W Oliver; Cogan, Nicola; McCabe, Dominick J H

    2011-06-01

    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 [κ = 0.28]. The two most unreliable components of the scoring system were clinical features [κ = 0.51], and duration of symptoms [κ = 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.

  9. [German neurology and neurologists during the Third Reich: exemplified by research on epilepsy].

    Science.gov (United States)

    Martin, M; Fangerau, H; Karenberg, A

    2016-08-01

    There are only a small number of studies dealing with the impact of eugenic theories and practices on the research of particular neurological diseases during the Third Reich. Thus, this contribution to the special issue on neurology in Germany between 1933 and 1945 focuses exemplarily on epilepsy research. By drawing on primary sources and secondary literature the article tries to reconstruct the scientific discourse of the time and consider the implications for patients. National socialistic ideology was based on eugenic thinking and the implementation of eugenic policies was a major political objective. An immediate effect of this policy was the passing of the Law for the Prevention of Genetically Diseased Offspring (Gesetz zur Verhütung erbkranken Nachwuchses) in 1933. According to this law "hereditary epilepsy" along with various other neurological and psychiatric disorders was regarded as a mandatory indication for forced sterilization. Subsequently, funding of epileptological research was generously increased and extended, e. g. at the German Research Institute (Deutsche Forschungsanstalt) in Munich and the Rheinische Provinzial-Institut in Bonn. The main focus was placed on idiopathic forms of the disease, which were a priori considered as hereditary. At the annual meetings of the Society of German Neurologists and Psychiatrists (Gesellschaft deutscher Neurologen und Psychiater), lectures and debates on epilepsy repeatedly constituted a key topic. Some participants opted for a broad interpretation of "endogeneity" and thus favored an extension of the practice of sterilization but others advocated a more differentiated and restricted attitude. Several neurology researchers showed a penchant for self-mobilization in line with the doctrine of the new government.

  10. Current clinical practice for Parkinson’s disease among Chinese physicians, general neurologists and movement disorders specialists: a national survey

    Directory of Open Access Journals (Sweden)

    Chen Wei

    2012-12-01

    Full Text Available Abstract Background To explore current status and choices regarding diagnosis and treatment of Parkinson’s disease (PD among physicians, general neurologists and movement disorders specialists in China via a national survey. Methods The cross-sectional questionnaire-based survey was conducted from November, 2010 to July, 2011. Six hundreds and twelve doctors from different cities in China were recruited for this study. Results 68.6% (n=420 and 23.9% (n=146 of doctors have read the national and international guidelines, respectively. There was a larger proportion of movement disorders specialists reading the guidelines, in contrast to physicians and general neurologists (P. Up to 76.4% (n=465 and 81.8% (n=498 of doctors would choose standard oral levodopa test and conventional MRI(with T1 and T2, respectively; Whereas susceptibility weighed imaging(SWI(16.1%; n=98, transcranial sonography (TCS (1.8%; n=11 and functional neuroimaging test, such as single photon emission computed tomography(SPECT (10.2%; n=62 and positron emission tomography(PET(13.3%; n=81 were less used for suspected patients with PD in clinical practice. Doctors at different levels or from different hospitals and cities would choose different medication for motor complications and non-motor symptoms of patients with PD, in addition to initial drug selection for newly diagnosed PD. Doctors who had read the guidelines had significantly better knowledge of medication selections for PD under specific circumstances. Conclusions Compared with commonly employed standard oral levodopa test and conventional MRI, SWI complements MRI, TCS and functional neuroimaging were less performed for diagnosis of PD in clinical practice in China. The choices of diagnostic methods and therapeutic strategy of PD vary among physicians, general neurologists and movement disorders specialists. Guideline awareness is markedly beneficial to reasonable PD medications strategy in China.

  11. 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.

  12. [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.

  13. Practices and views of neurologists regarding the use of whole-genome sequencing in clinical settings: a web-based survey.

    Science.gov (United States)

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

    2017-06-01

    The use of Whole-Genome Sequencing (WGS) in clinical settings has brought up a number of controversial scientific and ethical issues. The application of WGS is of particular relevance in neurology, as many conditions are difficult to diagnose. We conducted a worldwide, web-based survey to explore neurologists' views on the benefits of, and concerns regarding, the clinical use of WGS, as well as the resources necessary to implement it. Almost half of the 204 neurologists in the study treated mostly adult patients (48%), while the rest mainly children (37.3%), or both (14.7%). Epilepsy (73%) and headaches (57.8%) were the predominant conditions treated. Factor analysis brought out two profiles: neurologists who would offer WGS to their patients, and those who would not, or were not sure in which circumstances it should be offered. Neurologists considering the use of WGS as bringing more benefits than drawbacks currently used targeted genetic testing (PWGS' benefits were directed towards the patients, while its risks were of a financial and legal nature. Furthermore, there was a correlation between respondents' current use of genetic tests and an anticipation of increased use in the future (PWGS in their practice (53.5%). Our results highlight gaps in education, organization, and funding to support the use of WGS in neurology, and draw attention to the need for resources that could strongly contribute to more straightforward diagnoses and possibly better treatment of neurological conditions.

  14. Views on Careers in Clinical Neurosciences Among Neurosurgeons and Neurologists in China.

    Science.gov (United States)

    Lukas, Rimas V; Ma, Chao; Chen, Jingcao; Dong, Hongmei; Li, Jinxin; Wang, Zefen; Jiang, Ivy; Fu, Kai; Satnarayan, Samita; Albert, Dara V F; Sherer, Renslow

    2017-02-01

    China has a large and aging population. The need for physicians with training in clinical neurosciences will grow. There is little known regarding the factors that lead physicians in China to pursue careers in clinical neurosciences. The objective of this study was to garner a clearer understanding of factors that influence physicians to pursue careers in neurosurgery and neurology in China. We surveyed attendees at a national neuroscience conference on the factors that influence their pursuit of careers in clinical neurosciences. Responses were quantified on a Likert scale. One-way analysis of variance was used to compare different groups of respondents. Factors associated with the intellectual elements of the specialties were rated most highly. Differences were noted between respondents, with trainees rating lifestyle-related factors more highly compared with attending physicians. The intellectual challenges are important factors for physicians in China influencing the pursuit of careers in the clinical neurosciences. This finding echoes results found elsewhere in the world. However, differences with trainees elsewhere in the world emerge when evaluating additional factors influencing trainees pursuing careers in the clinical neurosciences. Trainees in China rate educational experiences and mentorship more highly, whereas U.S. trainees rate altruistic goals more highly. This study provides a clearer understanding of factors influencing career choice among clinical neuroscientists in China. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. 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

    2017-11-01

    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. © The Author 2017. Published by Oxford University Press.

  16. How Patient Demographics, Imaging, and Beliefs Influence Tissue-Type Plasminogen Activator Use: A Survey of North American Neurologists.

    Science.gov (United States)

    Shamy, Michel C F; Pugliese, Michael; Meisel, Karl; Rodriguez, Rosendo; Kim, Anthony S; Stahnisch, Frank W; Smith, Eric E

    2016-08-01

    Understanding physician decision making is increasingly recognized as an important topic of study, especially in stroke care. We sought to characterize the process of acute stroke decision making among neurologists in the United States and Canada from clinical and epistemological perspectives. Using a factorial design online survey, respondents were presented with clinical data to mimic an acute stroke encounter. The history, examination, computed tomographic (CT) scan, CT angiogram, and CT perfusion were presented in sequence, and respondents rated their diagnostic confidence and likelihood of treatment with tissue-type plasminogen activator after each element. Patient age, race, sex, and CT perfusion imaging results were randomized, whereas the rest of the clinical presentation was held constant. We collected 715 responses, of which 473 (66%) were complete. Diagnostic certainty and likelihood of treatment with tissue-type plasminogen activator rose incrementally as additional clinical data were provided. Diagnostic certainty and treatment likelihood were strongly influenced by the clinical history and the CT scan. Other factors such as physicians' personal beliefs or biases were not influential. Respondents' accuracy in interpreting CT angiographic and CT perfusion images was variable and generally low. Diagnostic certainty and likelihood of treatment with tissue-type plasminogen activator increase with additional clinical data, with the history being the most important factor for diagnostic and treatment decisions. Respondents had difficulty in interpreting the results of CT perfusion scans although they had little impact on treatment decisions. We did not identify treatment bias based on patient age, race, or sex. © 2016 American Heart Association, Inc.

  17. When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis.

    Science.gov (United States)

    Kachuck, Norman J

    2011-01-01

    New more powerful therapies for the treatment of multiple sclerosis may also confer a potential for unprecedented life-endangering side effects. How does a physician respond to a patient's request for a treatment the benefit of which cannot be clearly established as worth its risk? The current challenge with prescription of natalizumab (Tysabri(®), Biogen Idec) is used to illustrate how this conflict creates an opportunity to re-examine our goals as physicians and the nature of the physician-patient relationship. Understanding the physician's role in that partnership, and the ethical and psychological issues impacting on how reasonable risk is determined, can improve the neurologist's capacity to explicate such quandaries. Redefining what is required to mediate disagreement between doctors and patients about reasonable risk is at the heart of why many of us became physicians. However, such nuanced interpersonal dynamics of patient care can be neglected due to the time and resource pressures of our practices. These demands have increased the seductiveness of the efficiencies promoted by the trend toward the pseudo-objectification of evidence-based care, which has arguably monopolized the healing conversation often to the detriment of the shared narrative. We examine and attempt to reframe the fiduciary and biopsychosocial contretemps of the doctor and patient disagreeing on risk, emphasizing its humanistic, relational dimensions.

  18. When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Kachuck NJ

    2011-04-01

    Full Text Available Norman J KachuckUniversity of Southern California, Keck School of Medicine, Los Angeles, CA, USAAbstract: New more powerful therapies for the treatment of multiple sclerosis may also confer a potential for unprecedented life-endangering side effects. How does a physician respond to a patient's request for a treatment the benefit of which cannot be clearly established as worth its risk? The current challenge with prescription of natalizumab (Tysabri®, Biogen Idec is used to illustrate how this conflict creates an opportunity to re-examine our goals as physicians and the nature of the physician-patient relationship. Understanding the physician's role in that partnership, and the ethical and psychological issues impacting on how reasonable risk is determined, can improve the neurologist's capacity to explicate such quandaries. Redefining what is required to mediate disagreement between doctors and patients about reasonable risk is at the heart of why many of us became physicians. However, such nuanced interpersonal dynamics of patient care can be neglected due to the time and resource pressures of our practices. These demands have increased the seductiveness of the efficiencies promoted by the trend toward the pseudoobjectification of evidence-based care, which has arguably monopolized the healing conversation often to the detriment of the shared narrative. We examine and attempt to reframe the fiduciary and biopsychosocial contretemps of the doctor and patient disagreeing on risk, emphasizing its humanistic, relational dimensions.Keywords: multiple sclerosis, natalizumab, medical ethics, medical decision-making, patient-physician relationship

  19. ["I believe that I always had an impeccable attitude during this time": the paediatrician and neurologist Gertrud Soeken and national socialism].

    Science.gov (United States)

    Schwoch, Rebecca

    2006-01-01

    Gertrud Soeken (1897-1978), paediatrician as well as psychiatrist and neurologist, was involved in National Socialist medicine through her practical and scientific work. She supported both National Socialist health care and ideology. This article confronts her activities in science and health care politics with the strategy of her denazification proceedings, which ended with her suspension as chief physician in Berlin-Buch. The relevance of the professional network on which she was able to rely is particularly discussed.

  20. Dental care in patients with epilepsy: a survey of 82 patients and their attending dentists and neurologists in southern Germany.

    Science.gov (United States)

    Schöpper, Malin; Ludolph, Albert C; Fauser, Susanne

    2016-12-01

    The current study assessed the knowledge and attitudes of dentists and neurologists, and of their patients with epilepsy, in the catchment area of an outpatient clinic for epilepsy in southern Germany. One-hundred patients with epilepsy were asked to complete questionnaires about their dental treatment. Attitudes of their attending dentists and neurologists were also assessed. Patients with epilepsy: The questionnaires were returned by 82% of patients. Of these, 84% regularly (once or twice a year) sought out a dentist, 79% reported their epilepsy to the dentist, 6% were refused treatment by a dentist because of their epilepsy, 10% had already experienced a seizure while at a dental office and 52% wished for more detailed information pretreatment. Dentists: Although 97% treated patients with epilepsy, 21% believed that their equipment was inappropriate for treating a patient experiencing seizures. The majority were not familiar with interactions between antibiotics/analgetics and anti-epileptic drugs. Short-term general anaesthesia was preferred for critical patients by 70% of dentists, 70% recommended dental ceramic for prosthetic reconstruction of anterior teeth and 64% would not recommend use of a removable denture. Neurologists: Sixty-two per cent were asked for advice by their patients, 71% knew about particular risks and interactions between antibiotics/analgetics and anti-epileptic drugs, 8% would stop valproic acid before extensive dental intervention and 92% recommended general anaesthesia in critical patients (uncooperative patients, patients with learning difficulties, and patients with frequent generalised tonic-clonic or complex partial seizures). In general, patients were satisfied with their dental treatment. Regarding the clinician's role, however, dentists need to know more with respect to treating patients with seizures. Beyond that, it would be desirable for neurologists to take more time to answer their patients' questions regarding dental care

  1. 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.

  2. Effect of Template Reporting of Brain MRIs for Multiple Sclerosis on Report Thoroughness and Neurologist-Rated Quality: Results of a Prospective Quality Improvement Project.

    Science.gov (United States)

    Dickerson, Elliot; Davenport, Matthew S; Syed, Faiz; Stuve, Olaf; Cohen, Jeffrey A; Rinker, John R; Goldman, Myla D; Segal, Benjamin M; Foerster, Bradley R

    2017-03-01

    To assess the impact of structured reporting templates on the objective and subjective quality of radiology reports for brain MRIs in patients with multiple sclerosis (MS). A HIPAA-compliant prospective quality improvement initiative was undertaken to develop and implement a 12-item structured reporting template for brain MRI examinations in patients with known or suspected MS based on published guidelines. Reports created 1 year before implementing the template served as the baseline. A random sample of 10 template and 10 non-template reports was sent to five neurologists outside the study institution with MS expertise, who reviewed the reports for comprehensiveness and quality. The number of MS-relevant elements in template and non-template reports were compared with unpaired t tests. Proportions were compared with χ2 and Fisher exact tests. There were 63 reports in the pre-template period and 93 reports in the post-template period. Use of the template increased over time in the post-template period (P = .04). All 12 MS-relevant findings were addressed more often and with less variability in template reports: (11.1 ± 0.7 findings versus 5.8 ± 2.2 findings in non-template reports, P < .001). Neurologists were more likely to give the template reports the highest positive rating (56% [107/190] versus 28% [56/199], P < .001) and less likely to give the template reports a lower rating (7% [13/190] versus 15% [29/199], P = .01) compared with the non-template reports. Template reporting of brain MRI examinations increases the rate at which MS-relevant findings are included in the report. Standardized reports are preferred by neurologists with MS expertise. Copyright © 2016 American College of Radiology. All rights reserved.

  3. 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. 

  4. European Academy of Neurology/European Association for Palliative Care Taskforce on Neurology Consensus recommendations on palliative care for patients with chronic and progressive neurological disease - acceptability for Belgian neurologists.

    Science.gov (United States)

    Vanopdenbosch, L J; Maes, E; Oliver, D J

    2017-07-01

    A Consensus document on palliative care and neurology has made recommendations on the care of people with chronic and progressive neurological disease. This study aimed to investigate whether these recommendations are understood by, acceptable to and used in practice by neurologists in Belgium. An online survey was undertaken of 100 neurologists in Belgium, asking for their opinion on all of the recommendations in the Consensus document. Sixty-four of the neurologists replied. Overall, they expressed support for the recommendations, in particular open communication with patients, open assessment of patient and family needs, and discussion of dying. There was less understanding of the role of palliative care in the implementation of palliative care early in disease progression and the role of palliative care multidisciplinary teams. The survey shows that many of the recommendations in the European Academy of Neurology/European Association for Palliative Care Taskforce on Neurology Consensus document are understood by neurologists, and several are now seen as part of normal clinical practice. However, there is still a need to develop a more collaborative approach between neurology and palliative care services, for the benefit of patients and families. © 2017 EAN.

  5. Emergency computed tomography in patients with first seizure.

    Science.gov (United States)

    Kotisaari, Kaisa; Virtanen, Pekka; Forss, Nina; Strbian, Daniel; Scheperjans, Filip

    2017-05-01

    To determine the frequency of emergent imaging findings on head computed tomography (CT) in an adult population of first seizure (FS) patients presenting to an emergency department (ED); and to search for associations between clinical features and emergent imaging findings among these patients. For this retrospective registry-based study, adult FS patients presenting to Helsinki University Hospital ED in 2006 were identified based on ICD-10 diagnosis. Clinical parameters were extracted from patient records. A neuroradiologist blinded to clinical information reviewed the CT scans for emergent imaging findings prompting changes in acute treatment, predefined as intracranial haemorrhage, acute ischemia, central nervous system infection, mass effect, midline shift, obstructive hydrocephalus and/or brain oedema. 449 FS patients were identified, of which 416 (93%) had undergone emergency CT imaging. Of these, 49 (12%) had emergent imaging findings on non-contrast CT. Logistic regression suggested that headache (odds ratio (OR) 3.62, 95% confidence interval (CI) 1.30-10.12), focal motor sign in the ED (OR 3.23, 95% CI 1.58-6.62), history of malignancy (OR 3.05, 95% CI 1.17-7.92), and altered mental state in the ED (OR 2.27, 95% CI 1.15-4.49) were associated with emergent imaging findings on NCCT. Presence of at least one of these factors had 84% sensitivity for emergent imaging findings. In FS patients, clinical information can be used to guide imaging decisions in the ED. However, if emergency imaging is not performed, urgent outpatient imaging and pre-imaging follow up should be secured. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  6. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 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 ...

  7. 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.

  8. Que pacientes atende um neurologista? Alicerce de um currículo em neurologia Which patients does the neurologist assist? Basis for a curriculum in neurology

    Directory of Open Access Journals (Sweden)

    João Eliezer Ferri-de-Barros

    1996-12-01

    Full Text Available OBJETIVO: Apresentar os diagnósticos mais freqüentes em pacientes encaminhados a neurologistas e discutir a importância destes achados para a definição de um currículo em neurologia. EMBASAMENTO:O desenvolvimento de subespecialidades em neurologia tem interferido na definição do que deveria ser ensinado no treinamento de um médico ou de um neurologista. O conhecimento de quais são as doenças neurológicas mais comuns pode contribuir para a construção deste currículo. MÉTODO: Os diagnósticos iniciais de 1815 pacientes encaminhados a um ambulatório de neurologia, num hospital público universitário em São Paulo, Brasil, são analisados. RESULTADOS:Os diagnósticos mais comuns, em ordem decrescente de frequência, foram: cefaléia, epilepsia, transtornos mentais, doença encéfalo-vascular, traumatismo craniencefálico, polineuropatia, síndrome vestibular, paraparesia crural espástica, síndrome extrapiramidal, síndrome demencial, hipertensão intracraniana e paralisia facial. CONCLUSÕES: A importância das subespecialidades no currículo deve ser relacionada à frequência da doença neurológica na comunidade.OBJECTIVE: To present the most frequent diagnosis of patients referred to a neurologist and to discuss the importance of this finding for the definition of the curriculum in Neurology. BACKGROUND:The development of subespecialties of Neurology is interfering in the definition of what should be taught to train a physician or a neurologist. The knowledge of which are the most common neurological diseases may contribute to construct these curricula. METHOD:The initial diagnosis in 1815 outpatients referred to the neurologic service of an university-affiliated public hospital in São Paulo, Brazil, were analyzed. RESULTS: The most common diagnosis, in decreasing order of frequency, were: headache, epilepsy, mental disorders, cerebrovascular disease, head injury, polyneuropathy, vestibular syndrome, spastic crural

  9. Emergent geometry, emergent forces

    Science.gov (United States)

    Selesnick, S. A.

    2017-10-01

    We give a brief account of some aspects of Finkelstein’s quantum relativity, namely an extension of it that derives elements of macroscopic geometry and the Lagrangians of the standard model including gravity from a presumed quantum version of spacetime. These emerge as collective effects in this quantal substrate. Our treatment, which is largely self-contained, differs mathematically from that originally given by Finkelstein. Dedicated to the memory of David Ritz Finkelstein

  10. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... Emergency contraception most likely prevents pregnancy in the same way as regular birth control pills: By preventing ...

  11. Ophthalmic emergencies.

    Science.gov (United States)

    Mandell, Deborah C; Holt, Elaine

    2005-03-01

    Ophthalmic emergencies are common presenting complaints in an emergency room. Most ophthalmic emergencies can be treated and stabilized until an ophthalmologist can be consulted. Most ocular emergencies involve loss of vision, compromised globe integrity, or severe ocular pain. Delay in treating true emergencies may result ina blind eye or loss of an eye. This article discusses the clinical signs,diagnosis, and treatment as well as the prognosis of some of the more common ophthalmic emergencies.

  12. 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

  13. 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.

  14. Emergency Contraception

    Science.gov (United States)

    ... after unprotected sex. Often called the morning-after pill, emergency contraception pills (ECPs) are hormone pills that women ... Does It Cost? Depending on the types of pills, the emergency contraception pill costs between $10 and $80. An ...

  15. Emergency Checklist

    Science.gov (United States)

    ... Prevention Week National Prescription Drug Take-Back Day Emergency Checklist If someone may have been poisoned, call ... may save you from a visit to the emergency room. Below is a checklist to help you ...

  16. Obstetrical emergencies.

    Science.gov (United States)

    Biddle, D; Macintire, D K

    2000-05-01

    This article discusses different techniques that can be used in the diagnosis and treatment of obstetrical emergencies. Female reproductive emergencies commonly encountered by small animal practitioners include pyometra, dystocia, cesarean section, mastitis, eclampsia, uterine torsion, and uterine prolapse. A thorough knowledge of normal and abnormal reproductive behavior will aid the emergency veterinarian in successfully managing such cases. Timely diagnosis and treatment of these emergencies will often give a good outcome.

  17. 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...

  18. Reproductive emergencies.

    Science.gov (United States)

    Jutkowitz, L Ari

    2005-03-01

    The emergency clinician is frequently called on to manage problems relating to the female reproductive tract. Because owners sel-dom have the medical knowledge needed to differentiate normal from abnormal reproductive behaviors, they frequently look to the emergency veterinarian for guidance and information during and after parturition. For this reason, it is essential that the veterinarian have a good understanding of the normal reproductive cycle as well as the common emergencies that may occur. This article reviews the events surrounding normal parturition in the dog and cat and the reproductive emergencies seen most commonly in practice.

  19. Emergency Shelters

    DEFF Research Database (Denmark)

    Popovic Larsen, Olga; Lee, Daniel Sang-Hoon; Eskemose Andersen, Jørgen

    2013-01-01

    The report gives all the research, teaching, seminars carried in the duration of the shelter cluster. It concludes with proposing relevant research agendas in the field of emergency architecture......The report gives all the research, teaching, seminars carried in the duration of the shelter cluster. It concludes with proposing relevant research agendas in the field of emergency architecture...

  20. Oncologic emergencies.

    Science.gov (United States)

    Endicott, Melissa

    2003-05-01

    Cancer can lead to emergencies either due to the primary disease, or as a result of therapy. Appropriate diagnosis and rapid treatment of these conditions can result in survival of the patient. Whether chemotherapy is implemented or not, the clinician may be presented with a patient in need of emergency stabilization. Common occurring emergencies are related to effects of the cancer, ranging from immune dysfunction due to marrow infiltration to brain herniation due to increased intracranial pressure from neoplasia. Often adverse effects secondary to chemotherapy can cause emergency situations such as sepsis. Prompt diagnosis and treatment may result in a favorable outcome. Addressed in this chapter are commonly occurring emergencies and specific stabilizing treatments.

  1. 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...

  2. EMERGENCY TRIAGE

    OpenAIRE

    Renata Rajapakse

    2015-01-01

    This paper describes emergency triage. It presents the reasons for implementation of triage and its benefits. Focuses on the Manchester triage system, which is formally validated triage model in Slovenia.

  3. Emergency Response

    Science.gov (United States)

    Information for first responders, industry, federal, state and local governments on EPA's role and available resources for response to oil spills, chemical, biological, radiological releases, and large-scale national emergencies.

  4. 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...

  5. 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.

  6. 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.

  7. EMERGENCY CALLS

    CERN Document Server

    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 ...

  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 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.

  10. German Emergency Care in Neurosurgery and Military Neurology during World War II, 1939-1945.

    Science.gov (United States)

    Stahnisch, Frank W

    2016-01-01

    A critical analysis of the historical involvement of neurology and neurosurgery in military emergency care services enables us to better contextualize and appreciate the development of modern neurology at large. Wartime neurosurgery and civil brain science during the German Nazi period tightly coalesced in examining the specific injury types, which military neurosurgeons such as Wilhelm Toennis, Klaus Joachim Zuelch, and Georg Merrem encountered and treated based on their neurophysiological understanding gained from earlier peacetime research. Collaborative associations with Dr. Toennis in particular proved to be highly beneficial to other military neurologists and neurosurgeons during World War II and beyond. This article also discusses the prewar developments and considers the fate of German neurosurgeons and military neurologists after the war. The envisaged dynamic concepts of fast action, reaction, and recycling, which contemporary physicians had intensively studied in the preceding scientific experiments in their neurophysiological laboratories, had already been introduced into neurological surgery during the interwar period. In retrospect, World War II emergency rescue units greatly strengthened military operations through an active process of 'recycling' indispensable army personnel. Neurosurgical emergency chains thereby introduced another decisive step in the modernization of warfare, in that they increased the momentum of military mobility in the field. Notwithstanding the violence of warfare and the often inhumane ways in which such knowledge in the field of emergency neurology was gained, the protagonists among the group of experts in military neurology and neurosurgery strongly contributed to the postwar clinical neuroscience community in Germany. In differing political pretexts, this became visible in both East Germany and West Germany after the war, while the specific military and political conditions under which this knowledge of emergency medicine

  11. Dermatologic emergencies.

    Science.gov (United States)

    Chacon, Anna H

    2015-02-01

    Although dermatology may be regarded as a medical specialty with few emergencies, they do exist and range from primary cutaneous disorders to severe systemic conditions with skin manifestations. Prompt recognition for appropriate diagnosis and treatment often is necessary to improve a patient's prognosis and a single decision can mark the difference between life and death.

  12. 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...

  13. 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...

  14. Neurosurgical emergencies.

    Science.gov (United States)

    Kapatkin, A S; Vite, C H

    2000-05-01

    The neurologic patient is considered a neurosurgical emergency when delay of treatment may influence the patient's outcome. Diseases of the spinal cord, brain, and peripheral nerves are presented in this article. Diagnostic tools (i.e., advanced imaging and electrophysiologic tests), differential diagnoses, treatment options (conventional and controversial), whether the patient requires surgery, and the optimal time for surgical intervention are discussed.

  15. 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.

  16. 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

  17. Gastrointestinal emergencies.

    Science.gov (United States)

    Aronson, L R; Brockman, D J; Brown, D C

    2000-05-01

    The animal with a surgical gastrointestinal emergency usually requires a rapid, thorough physical examination with concurrent resuscitation. As the diagnosis is being made, the animal must be made as stable as possible before undergoing general anesthesia. During surgery, there must be a critical evaluation of gastrointestinal viability and the use of precise technical skills to achieve the best outcome. Adept postoperative management, including careful monitoring and an index of suspicion for potential complications, is vital.

  18. 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...

  19. 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 ...

  20. Emerging Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter

    abroad. Even though FDI usually constitutes only a minor part of countries' total capital formation, the relationships between FDI and economic growth, welfare, and industrial upgrading in developing countries have been the object of long and extensive treatment in the literature. However, the literature...... 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......859 billion in 2003, up from USD129 billion in 1990, and has increased 11 times since 1985. A limited number of recent studies do exist, though (e.g. Cai 1999; Lecraw 1993; van Hoesel 1999; Tolentino 1993; Andreff 2003; Chudnovsky and López 2000; Bulatov 1998, Yeung 2000). Furthermore, academic...

  1. Emergencies and Emergency Permits for Ocean Dumping

    Science.gov (United States)

    Emergency permits under the MPRSA are issued if disposed material poses a threat to human health. Information is provided on emergency permit examples and disposal sites. Emergencies to safeguard life at sea does not require an ocean dumping permit.

  2. Emergency contraception.

    Science.gov (United States)

    Gemzell-Danielsson, Kristina; Rabe, Thomas; Cheng, Linan

    2013-03-01

    There have been numerous attempts to control fertility after unprotected sexual intercourse (UPSI). From very bizarre methods like the vaginal application of Coca Cola to the more serious attempts using calcium antagonists influencing fertility parameters in sperm to hormonal methods or intrauterine devices. So far, hormonal methods preventing or delaying ovulation have proved to be the most popular starting with the combination of ethinyl estradiol and levonorgestrel (LNG), known as the Yuzpe regimen. The first dose had to be taken within 72 hours of UPSI, a second one 12 hours later. Later on, LNG alone, at first in a regimen similar to the Yuzpe method (2 × 0.75 mg 12 hours apart) showed to be more successful, eventually resulting in the development of a 1.5 mg LNG pill that combined good efficacy with a high ease of use. Several efficacious and easy to use methods for emergency contraception (EC) are available on the market today with the most widely spread being LNG in a single dose of 1.5 mg (given as one tablet of 1.5 mg or 2 tablets of 0.75 mg each) for administration up to 3 days (according to WHO up to 5 days) after UPSI. Its limitations are the non-optimal efficacy which is decreasing the later the drug is taken and the fact that it is only approved for up to 72 hours after UPSI. This regimen has no effect on the endometrium, corpus luteum function and implantation, is not abortive and don't harm the fetus if accidentally taken in early pregnancy. It has no impact on the rate of ectopic pregnancies. It has become the standard method used up to this day in most countries. Since the mid 1970s copper IUDs have been used for EC, which show a high efficacy. Their disadvantages lie in the fact that EC is considered an off label use for most IUDs (not for the GynFix copper IUD in the European Union) and that they might not be acceptable for every patient. Furthermore IUD-insertion is an invasive procedure and it is required trained providers and

  3. Emerging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Shin-yee

    1993-03-01

    The mission of the Emerging Technologies thrust area at Lawrence Livermore National Laboratory is to help individuals establish technology areas that have national and commercial impact, and are outside the scope of the existing thrust areas. We continue to encourage innovative ideas that bring quality results to existing programs. We also take as our mission the encouragement of investment in new technology areas that are important to the economic competitiveness of this nation. In fiscal year 1992, we have focused on nine projects, summarized in this report: (1) Tire, Accident, Handling, and Roadway Safety; (2) EXTRANSYT: An Expert System for Advanced Traffic Management; (3) Odin: A High-Power, Underwater, Acoustic Transmitter for Surveillance Applications; (4) Passive Seismic Reservoir Monitoring: Signal Processing Innovations; (5) Paste Extrudable Explosive Aft Charge for Multi-Stage Munitions; (6) A Continuum Model for Reinforced Concrete at High Pressures and Strain Rates: Interim Report; (7) Benchmarking of the Criticality Evaluation Code COG; (8) Fast Algorithm for Large-Scale Consensus DNA Sequence Assembly; and (9) Using Electrical Heating to Enhance the Extraction of Volatile Organic Compounds from Soil.

  4. Emerging memories

    Science.gov (United States)

    Baldi, Livio; Bez, Roberto; Sandhu, Gurtej

    2014-12-01

    Memory is a key component of any data processing system. Following the classical Turing machine approach, memories hold both the data to be processed and the rules for processing them. In the history of microelectronics, the distinction has been rather between working memory, which is exemplified by DRAM, and storage memory, exemplified by NAND. These two types of memory devices now represent 90% of all memory market and 25% of the total semiconductor market, and have been the technology drivers in the last decades. Even if radically different in characteristics, they are however based on the same storage mechanism: charge storage, and this mechanism seems to be near to reaching its physical limits. The search for new alternative memory approaches, based on more scalable mechanisms, has therefore gained new momentum. The status of incumbent memory technologies and their scaling limitations will be discussed. Emerging memory technologies will be analyzed, starting from the ones that are already present for niche applications, and which are getting new attention, thanks to recent technology breakthroughs. Maturity level, physical limitations and potential for scaling will be compared to existing memories. At the end the possible future composition of memory systems will be discussed.

  5. Emergency teams in Danish emergency departments

    DEFF Research Database (Denmark)

    Lafrenz, Thomas; Lindberg, Søren Østergaard; La Cour, Jeppe Lerche

    2012-01-01

    The use of designated emergency teams for cardiac arrest and trauma patients is widely implemented. However, the use of designated teams in Danish emergency departments (EDs) has not been investigated. Our aim was to investigate the use and staffing of emergency teams in Danish EDs.......The use of designated emergency teams for cardiac arrest and trauma patients is widely implemented. However, the use of designated teams in Danish emergency departments (EDs) has not been investigated. Our aim was to investigate the use and staffing of emergency teams in Danish EDs....

  6. 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.

  7. Emergency teams in Danish emergency departments

    DEFF Research Database (Denmark)

    Lafrenz, Thomas; Lindberg, Søren Østergaard; La Cour, Jeppe Lerche

    2012-01-01

    The use of designated emergency teams for cardiac arrest and trauma patients is widely implemented. However, the use of designated teams in Danish emergency departments (EDs) has not been investigated. Our aim was to investigate the use and staffing of emergency teams in Danish EDs....

  8. Emergency Medical Services

    Science.gov (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people ... facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  9. 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 ...

  10. 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...

  11. A decade of emerging indications: deep brain stimulation in the United States.

    Science.gov (United States)

    Youngerman, Brett E; Chan, Andrew K; Mikell, Charles B; McKhann, Guy M; Sheth, Sameer A

    2016-08-01

    OBJECTIVE Deep brain stimulation (DBS) is an emerging treatment option for an expanding set of neurological and psychiatric diseases. Despite growing enthusiasm, the patterns and implications of this rapid adoption are largely unknown. National trends in DBS surgery performed for all indications between 2002 and 2011 are reported. METHODS Using a national database of hospital discharges, admissions for DBS for 14 indications were identified and categorized as either FDA approved, humanitarian device exempt (HDE), or emerging. Trends over time were examined, differences were analyzed by univariate analyses, and outcomes were analyzed by hierarchical regression analyses. RESULTS Between 2002 and 2011, there were an estimated 30,490 discharges following DBS for approved indications, 1647 for HDE indications, and 2014 for emerging indications. The volume for HDE and emerging indications grew at 36.1% annually in comparison with 7.0% for approved indications. DBS for emerging indications occurred at hospitals with more neurosurgeons and neurologists locally, but not necessarily at those with the highest DBS caseloads. Patients treated for HDE and emerging indications were younger with lower comorbidity scores. HDE and emerging indications were associated with greater rates of reported complications, longer lengths of stay, and greater total costs. CONCLUSIONS DBS for HDE and emerging indications underwent rapid growth in the last decade, and it is not exclusively the most experienced DBS practitioners leading the charge to treat the newest indications. Surgeons may be selecting younger and healthier patients for their early experiences. Differences in reported complication rates warrant further attention and additional costs should be anticipated as surgeons gain experience with new patient populations and targets.

  12. Pediatric ocular emergencies.

    Science.gov (United States)

    Hamilton, H L

    1999-07-01

    There are few ocular emergencies that are unique to the pediatric patient. Most ocular emergencies are traumatic in origin, and the prognosis is often determined by the extent of the injury. Some congenital anomalies that may present as ocular emergencies are also discussed. The focus of this article is recognition and initial therapy for the more common pediatric ocular emergencies.

  13. Is advanced neuroimaging for neuroradiologists? A systematic review of the scientific literature of the last decade.

    Science.gov (United States)

    Cocozza, Sirio; Russo, Camilla; Pontillo, Giuseppe; Ugga, Lorenzo; Macera, Antonio; Cervo, Amedeo; De Liso, Maria; Di Paolo, Nilde; Ginocchio, Maria Isabella; Giordano, Flavio; Leone, Giuseppe; Rusconi, Giovanni; Stanzione, Arnaldo; Briganti, Francesco; Quarantelli, Mario; Caranci, Ferdinando; D'Amico, Alessandra; Elefante, Andrea; Tedeschi, Enrico; Brunetti, Arturo

    2016-12-01

    To evaluate if advanced neuroimaging research is mainly conducted by imaging specialists, we investigated the number of first authorships by radiologists and non-radiologist scientists in articles published in the field of advanced neuroimaging in the past 10 years. Articles in the field of advanced neuroimaging identified in this retrospective bibliometric analysis were divided in four groups, depending on the imaging technique used. For all included studies, educational background of the first authors was recorded (based on available online curriculum vitae) and classified in subgroups, depending on their specialty. Finally, journal impact factors were recorded and comparatively assessed among subgroups as a metric of research quality. A total number of 3831 articles were included in the study. Radiologists accounted as first authors for only 12.8 % of these publications, while 56.9 % of first authors were researchers without a medical degree. Mean impact factor (IF) of journals with non-MD researchers as first authors was significantly higher than the MD subgroup (p articles authored by other MD specialists (p articles was the lowest among all subgroups. These results, taken together, should question the radiology community about its future role in the development of advanced neuroimaging.

  14. 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.)

  15. [Consideration of guidelines, recommendations and quality indicators for treatment of stroke in the dataset "Emergency Department" of DIVI].

    Science.gov (United States)

    Kulla, M; Friess, M; Schellinger, P D; Harth, A; Busse, O; Walcher, F; Helm, M

    2015-12-01

    The dataset "Emergency Department" of the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI) has been developed during several expert meetings. Its goal is an all-encompassing documentation of the early clinical treatment of patients in emergency departments. Using the example of the index disease acute ischemic stroke (stroke), the aim was to analyze how far this approach has been fulfilled. In this study German, European and US American guidelines were used to analyze the extent of coverage of the datasets on current emergency department guidelines and recommendations from professional societies. In addition, it was examined whether the dataset includes recommended quality indicators (QI) for quality management (QM) and in a third step it was examined to what extent national provisions for billing are included. In each case a differentiation was made whether the respective rationale was primary, i.e. directly apparent or whether it was merely secondarily depicted by expertise. In the evaluation an additional differentiation was made between the level of recommendations and further quality relevant criteria. The modular design of the emergency department dataset comprising 676 data fields is briefly described. A total of 401 individual fields, divided into basic documentation, monitoring and specific neurological documentation of the treatment of stroke patients were considered. For 247 data fields a rationale was found. Partially overlapping, 78.9 % of 214 medical recommendations in 3 guidelines and 85.8 % of the 106 identified quality indicators were primarily covered. Of the 67 requirements for billing of performance of services, 55.5 % are primarily part of the emergency department dataset. Through appropriate expertise and documentation by a board certified neurologist, the results can be improved to almost 100 %. The index disease stroke illustrates that the emergency department dataset of the DIVI covers medical

  16. 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...

  17. Emergency airway puncture - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100113.htm Emergency airway puncture - series—Normal anatomy To use the ... 2016 Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also ...

  18. Costs of Emergency Care

    Science.gov (United States)

    American College of Emergency Physicians | News Room - Fact Sheets Newsroom Site Navigation News Releases Get News Alerts by Email All RSS Feeds ACEP ... Contact Us Site Body Main Content Annals of Emergency Medicine | EMAF Website | ACEP Policy Statements | ACEP Now | ...

  19. Emergency airway puncture

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003017.htm Emergency airway puncture To use the sharing features on this page, please enable JavaScript. Emergency airway puncture is the placement of a hollow ...

  20. 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 c...

  1. Dog Bite Emergencies

    Science.gov (United States)

    ... Emergency Care Animal Welfare Veterinary Careers Public Health Dog bite emergencies What do I do if I’ ... vaccination records. What do I do if my dog bites someone? Dog bites are scary for everyone ...

  2. Management of pediatric patients with concussion by emergency medicine physicians.

    Science.gov (United States)

    Kinnaman, Karen A; Mannix, Rebekah C; Comstock, R Dawn; Meehan, William P

    2014-07-01

    respondents refer their patients to a neuropsychologist. When discussing discharge instructions, 86% of the clinicians recommended follow-up with a primary care physician, 62% of the clinicians recommended follow-up with a sports concussion clinic, and 11% of the clinicians recommend follow-up with a neurologist. Most respondents (70%) have access to a designated sports concussion clinic. Nearly all emergency medicine physicians surveyed care for pediatric patients with concussion, most by using published guidelines. Emergency medicine physicians routinely use medications to treat the symptoms of concussion and often refer patients to primary care physicians as well as designated sports concussion clinics for follow-up.

  3. Modelling weed emergence patterns

    NARCIS (Netherlands)

    Vleeshouwers, L.M.

    1997-01-01

    Anticipating weed pressure may be important in selecting and timing weed control measures in order to optimize their effectiveness, and thus reduce herbicide use. Therefore, a predictive model of the time of emergence and the numbers of seedling emerging (the weed emergence pattern) after

  4. 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.

  5. 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.

  6. 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.>.

  7. 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.

  8. 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.

  9. Flux Emergence (Theory

    Directory of Open Access Journals (Sweden)

    Mark C. M. Cheung

    2014-07-01

    Full Text Available Magnetic flux emergence from the solar convection zone into the overlying atmosphere is the driver of a diverse range of phenomena associated with solar activity. In this article, we introduce theoretical concepts central to the study of flux emergence and discuss how the inclusion of different physical effects (e.g., magnetic buoyancy, magnetoconvection, reconnection, magnetic twist, interaction with ambient field in models impact the evolution of the emerging field and plasma.

  10. Thermodynamics and emergent universe

    OpenAIRE

    Ghosh, Saumya; Gangopadhyay, Sunandan

    2016-01-01

    We show that in the isentropic scenario the first order thermodynamical particle creation model gives an emergent universe solution even when the chemical potential is non-zero. However there exists no emergent universe scenario in the second order non-equilibrium theory for the particle creation model. We then point out a correspondence between the particle creation model with barotropic equation of state and the equation of state giving rise to an emergent universe without particle creation...

  11. Tuberculosis in complex emergencies.

    Science.gov (United States)

    Coninx, Rudi

    2007-08-01

    This paper describes the key factors and remaining challenges for tuberculosis (TB) control programmes in complex emergencies. A complex emergency is "a humanitarian crisis in a country, region or society where there is total or considerable breakdown of authority resulting from internal or external conflict and which requires an international response that goes beyond the mandate or capacity of any single agency and/or the ongoing United Nations country programme." Some 200 million people are believed to live in countries affected by complex emergencies; almost all of these are developing countries that also bear the main burden of TB. The effects of complex emergencies impact on TB control programmes, interfering with the goals of identifying and curing TB patients and possibly leading to the emergence of MDR-TB. There are many detailed descriptions of aid interventions during complex emergencies; yet TB control programmes are absent from most of these reports. If TB is neglected, it may quickly result in increased morbidity and mortality, as was demonstrated in Bosnia and Herzegovina and in Somalia. TB is a major disease in complex emergencies and requires an appropriate public health response. While there is no manual to cover complex emergencies, the interagency manual for TB control in refugee and displaced populations provides valuable guidance. These programmes contribute to the body of evidence needed to compile such a manual, and should ensure that the experiences of TB control in complex emergencies lead to the establishment of evidence-based programmes.

  12. 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,...

  13. Emergency care of reptiles.

    Science.gov (United States)

    Martinez-Jimenez, David; Hernandez-Divers, Stephen J

    2007-05-01

    Most reptile emergencies are the result of improper husbandry and nutrition. Reptiles are good at masking disease, and owners, failing to recognize early signs of illness, only seek veterinary assistance when issues are advanced and near terminal. The veterinarian should be familiar with reptile species-specific husbandry and nutritional requirements and basic clinical techniques. The same principles and techniques used in small animal medicine can be applied to reptile emergencies. This article reviews general emergency principles that apply to the reptilian patient and common emergency presentations. The main areas of discussion focus on cardiopulmonary resuscitation, fluid therapy, and analgesia.

  14. EMERGE-ing from the Shadows

    Science.gov (United States)

    Grier, Terry B.

    2014-01-01

    Houston school officials noticed their best performing low-income students weren't applying to Ivy League and selective colleges. In response, they created EMERGE, a program that develops and guides talented youths toward a top-college path.

  15. 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

  16. 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 on ...

  17. 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....

  18. Emergency Notification Strategy

    Science.gov (United States)

    Katsouros, Mark

    2014-01-01

    In higher education, the IT department is often the service provider for the institution's emergency notification system (ENS). For many institutions, the complexity of providing emergency notification to students, faculty, and staff makes using a local, on-premise solution unrealistic. But finding the right commercially hosted technical solution…

  19. Common eye emergencies

    African Journals Online (AJOL)

    2007-10-11

    Oct 11, 2007 ... Common eye emergencies may present as an acute red eye, sudden visual loss or acute ocular trauma. Most eye emergencies will require referral to an ophthalmologist after initial basic examination and primary management. A relevant history of onset and symptoms of the current problem must be ...

  20. Birth and Emergency Planning

    African Journals Online (AJOL)

    AJRH Managing Editor

    Overall, 62% had a birth plan, 74% had adequate knowledge of danger signs, while 64% and 37% reported maternal and newborn complications ... Knowledge of danger signs was associated with birth and emergency planning, and birth and emergency planning was associated with .... Materials and Methods. Study site.

  1. 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....

  2. 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.

  3. Focus on emergency medicine.

    Science.gov (United States)

    2014-01-18

    Manuela Herrera reports from the 10th Emergency and Critical Care UK annual congress, hosted by Vets Now, which was held in Harrogate last November. More than 500 small animal veterinary surgeons, veterinary nurses, practice managers and receptionists attended the meeting to learn more about all aspects of emergency care.

  4. 7. Emergency contraception

    African Journals Online (AJOL)

    Sitwala

    Unintended pregnancies, carrying enormous costs to individuals and societies, are largely preventable with improved use of Emergency Contraceptive pills. The full potential of emergency contraception can be realized only when people, especially women are made aware of the existence of these methods and the need.

  5. Electric power emergency handbook

    Energy Technology Data Exchange (ETDEWEB)

    Labadie, J.R.

    1980-09-01

    The Emergency Electric Power Administration's Emergency Operations Handbook is designed to provide guidance to the EEPA organization. It defines responsibilities and describes actions performed by the government and electric utilities in planning for, and in operations during, national emergencies. The EEPA Handbook is reissued periodically to describe organizational changes, to assign new duties and responsibilities, and to clarify the responsibilities of the government to direct and coordinate the operations of the electric utility industry under emergencies declared by the President. This Handbook is consistent with the assumptions, policies, and procedures contained in the National Plan for Emergency Preparedness. Claimancy and restoration, communications and warning, and effects of nuclear weapons are subjects covered in the appendices.

  6. Energy emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, B.K.; Rothkopf, M.H.

    1988-06-01

    Energy emergency preparedness is the special responsibility of the Deputy Assistant Secretary of Energy Emergencies within the Office of the Assistant Secretary for International Affairs and Energy Emergencies; though other Department of Energy (DOE) offices manage some aspects and DOE also coordinates emergency management with other federal departments. There are two basic objectives for energy emergency preparedness. The first of these, the economic stabilization objective, seeks to ease the impact of an energy supply disruption by facilitating a quick recovery and minimizing the disruption's economic consequences. The second is the mobilization support objective to ensure that there is adequate energy and fuel to support defense, defense industrial and critical civilian needs for energy and fuel. While all energy systems are vulnerable they vary in the degree of seriousness and the probability of a disruption. Oil is the most vulnerable, and will become increasingly so in the 1990's, as domestic and reliable foreign sources diminish and the United States relies more on imports from volatile Persian Gulf countries. Electric power is the next most vulnerable system, being open particularly to multi-site terrorist attack. This overview examines two highly connected organizations: the Office of Energy Emergencies (OEE) itself and the actual response organization, centering on the Energy Emergency Management System (EEMS). 38 refs., 10 figs.

  7. How and when to refer patients diagnosed with primary headache and craniofacial neuralgia in the Emergency department or Primary Care: Recommendations of the Spanish Society of Neurology's Headache Study Group.

    Science.gov (United States)

    Gago-Veiga, A B; García-Azorín, D; Mas-Sala, N; Ordás, C M; Ruiz-Piñero, M; Torres-Ferrús, M; Santos-Lasaosa, S; Viguera Romero, J; Pozo-Rosich, P

    2017-09-01

    When a patient is diagnosed with primary headache or craniofacial neuralgia in the emergency department or in primary care, and is referred to a neurologist due to the complexity of the case, it is useful to know whether additional examination should be sought and the priority (urgent, preferential or normal) with which the patient should be seen. This will avoid unnecessary delays in patients with disabling headache and where organic causes are suspected. In order to issue recommendations on this matter, the Spanish Society of Neurology's Headache Study Group has decided to create a series of agreed recommendations constituting a referral protocol for patients with headache and/or craniofacial neuralgia. Young neurologists with an interest and experience in headache were invited to draft a series of practical guidelines in collaboration with Spanish Society of Neurology's Headache Study Group Executive Committee. For practical reasons, the document was divided into 2 articles: this first article focuses on primary headaches and craniofacial neuralgias and the second on secondary headaches. In order for the recommendations to be helpful for daily practice they follow a practical approach, with tables summarising referral criteria, examinations to be performed, and referral to other specialists. We hope to offer a guide and tools to improve decision-making regarding patients with headache, identifying complementary tests to prioritise and referral pathways to be followed, in order to avoid duplicated consultations and delayed diagnosis and treatment. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  8. Improving Clinical Information on Head CT Requisitions From the Emergency Department to Aid Interpretation and Billing Efficiency.

    Science.gov (United States)

    Barron, Dillon; Spiegel, Thomas; Katzman, Gregory L; Haas, Kateland; Ali, Saad

    2018-01-01

    The accuracy of radiologic interpretations is higher when appropriate clinical information is provided, as is the likelihood of reimbursement for the studies. The purpose of this project was to evaluate and improve the quality of clinical information provided on head CT requisitions from an urban emergency department (ED). In a prospective study conducted from July 2015 to May 2016, attending neuroradiologists evaluated 1100 randomly selected ED requisitions for unenhanced head CT, grading them for clinical and billing adequacy on a scale of 0-2. After acquisition of baseline data (400 studies), an intervention was performed that consisted of education of ED staff on the importance of clinical information in requisitions. A reminder slide was placed on a large screen in the ED staff working area with examples of appropriate history. Postintervention data (700 studies) were subsequently obtained. Mean scores and payment lag time before versus after the intervention were compared by Wilcoxon rank sum test. Statistically significant improvement was found in mean scores after the intervention for both clinical (1.32 to 1.43, p = 0.003) and billing (1.64 to 1.74, p = 0.02) adequacy categories. The percentage of studies with a score of 2 increased in both categories, and the percentages of 0 and 1 scores declined. There was a 21.1-day decrease in payment lag time (from 75.8 to 54.7 days, p < 0.0001). The quality of clinical information provided on imaging requisitions by ED faculty and residents improved after a fairly simple intervention. Billing efficiency improved, and payment lag time decreased substantially.

  9. 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.

  10. 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...... negotiation and transformation, and are mediated by design artefacts during an Inspiration Card Workshop, a collaborative event in which findings from domain studies are combined with technological sources of inspiration, in order to generate design concepts. We present a micro-analytic study......, artefactually mediated, adaptive and emergent....

  11. [Improving emergency department organisation].

    Science.gov (United States)

    Yordanov, Youri; Beltramini, Alexandra; Debuc, Erwan; Pateron, Dominique

    2015-01-01

    Emergency departments use has been constantly increasing over the world. Overcrowding is defined as a situation which compromises patient safety because of delayed cares. This situation is often reached. Emergency departments have to continuously improve their organization to be able to ensure the same quality of care to a higher number of patients. Thus a good organization is essential: it doesn't always avoid overcrowding. The rest of the hospital has to be involved in this process to ensure efficiency. We examine the various interventions and procedures that can be found in medical literature for improving patients flow and management in emergency departments.

  12. Emergency Lightning System

    Science.gov (United States)

    1980-01-01

    Super Vacuum Manufacturing Company's Stem-Lite Emergency Lighting System is widely used by fire, police, ambulance and other emergency service departments. The lights -- four floodlights which provide 2,000 watts of daytime equivalent visibility and a high-intensity flashing beacon can be elevated 10 feet above the roof of an emergency vehicle by means of an extendible mast. The higher elevation expands the effective radius of the floodlights and increases the beacon's visibility to several miles affording extra warning time to approaching traffic. When not in use, the light can be retracted into the compact rooftop housing. Stem-Lite also includes a generator which can serve to power such emergency equipment as pumps and drills, and a dashboard-mounted control panel for switching the lights and extending or retracting the mast.

  13. Natural Gas Emergencies

    Science.gov (United States)

    ... in your yard. That call could prevent a home emergency. Do not use light switches, electrical appliances or phones (cell or land line) in the affected home or building. Text adapted from "Are You Prepared?" ...

  14. 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.

  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. 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:...

  17. Hypoglycemia in Emergency Department

    Directory of Open Access Journals (Sweden)

    Yu-Jang Su

    2015-03-01

    Conclusions: When hypoglycemic patients present in the emergency department, physicians should pay attention to the presence of infection, malignancy, liver diseases (liver cirrhosis and biliary tract infection, and acute renal failure.

  18. 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.......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....

  19. Micronutrients in Emergencies

    OpenAIRE

    Patrick Webb; Andrew Thorne-Lyman

    2005-01-01

    This chapter explores two main aspects of the micronutrient problem as it relates to entitlements in humanitarian emergencies: the diseases that arise directly or indirectly as a result of vitamin and mineral deficiencies often fatal in their own right; and knowledge, or awareness, of micronutrient concerns (and solutions) among income poor households. The delivery of nutrients in emergencies is a key aspect of all relief operations today, but that in itself is insufficient without empowering...

  20. Emergency Management: Guidelines for Emergency Manager's Competency Model Formation

    National Research Council Canada - National Science Library

    2015-01-01

      On the grounds of contemporary understanding of emergency management and basing on the general interdisciplinary approach, the article examines competencies necessary for nowadays emergency managers...

  1. Characterizing emergency departments to improve understanding of emergency care systems.

    Science.gov (United States)

    Steptoe, Anne P; Corel, Blanka; Sullivan, Ashley F; Camargo, Carlos A

    2011-07-14

    International emergency medicine aims to understand different systems of emergency care across the globe. To date, however, international emergency medicine lacks common descriptors that can encompass the wide variety of emergency care systems in different countries. The frequent use of general, system-wide indicators (e.g. the status of emergency medicine as a medical specialty or the presence of emergency medicine training programs) does not account for the diverse methods that contribute to the delivery of emergency care both within and between countries. Such indicators suggest that a uniform approach to the development and structure of emergency care is both feasible and desirable. One solution to this complex problem is to shift the focus of international studies away from system-wide characteristics of emergency care. We propose such an alternative methodology, in which studies would examine emergency department-specific characteristics to inventory the various methods by which emergency care is delivered. Such characteristics include: emergency department location, layout, time period open to patients, and patient type served. There are many more ways to describe emergency departments, but these characteristics are particularly suited to describe with common terms a wide range of sites. When combined, these four characteristics give a concise but detailed picture of how emergency care is delivered at a specific emergency department. This approach embraces the diversity of emergency care as well as the variety of individual emergency departments that deliver it, while still allowing for the aggregation of broad similarities that might help characterize a system of emergency care.

  2. [Emergency Radiology layout].

    Science.gov (United States)

    Casciani, E; Bertini, L; Lanciotti, S; Campagnano, S; Valentini, C; De Cicco, M L; Polettini, E; Gualdi, G F

    2009-01-01

    The purpose of Radiologic Unit in Emergency is to reach diagnostic and therapeutic effectiveness in the best way and in less time possible. The Portable Ultrasound Device is an instrument necessary in Emergency Room and in ambulance/helicopter to evaluate the evidence of endoperitoneal bleeding. The CT is the radiologic methodic more fast that permits a complete evaluation of all body segments in traumatized patient in the famous "golden hour" after the trauma, therefore it would be placed in Emergency Area. The multislice CT brought to a reduction of morbidity and mortality, thanks to a quick acquisition, to a thin collimation, to a more spatial resolution and to an optimal vessel opacization, determining a saving of hospital global costs, therefore a reduction of percentage of not necessaries operations and permitting a more rapid diagnosis, obtaining a considerable reduction of waiting in Trauma Emergency Room with more rapid and aimed therapies and a consequent costs reduction. To satisfy a so wide question of radiologic exams necessaries devices are informatic systems completely connected between Radiology department and other departments. Main advantages of MR in Emergency are the use of non ionising radiations, the possibility to effect diffusion and perfusion studies and to evaluate spinal cord damage. Reduction of time of patient preparation and times of acquisition and elaboration of imagines by modern and performant devices is basic to make more rapid therapeutic decisions.

  3. The Emerging City

    DEFF Research Database (Denmark)

    Samson, Kristine

    milieu and how other meanings emerge. In the last example, Relocation of beer drinkers on Enghave Square, Copenhagen, I will highlight how a heterogeneous assemblages of architecture, urban design, artistic intervention and every day social life has constructed continuums of intensities over a period...... of time thus establishing an emergent urban space divergent from both the intentions of the planner, architect, artist and user. Through the examples, I suggest that each urban body or design deterritorialize connecting with the city. Broadening up the perspective, I ask whether philosophical aesthetics...... associated with architecture and design can be redefined in terms of an emergent urbanity. Here socio-material assemblages play an important role as milieus are created as temporary intensities as they constantly territorialize and deterritorialize urban space. According to this, I define the city close...

  4. 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.

  5. Emergency peripartum hysterectomy

    DEFF Research Database (Denmark)

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

    2015-01-01

    .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...... 7 days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period. MAIN OUTCOME MEASURES: Emergency peripartum hysterectomy rate. RESULTS: The total number of emergency...... 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...

  6. 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...... emergency control to render post-fault dynamics from the critical/emergency fault cleared state to the stable equilibrium point. This is a new control paradigm that does not rely on any continuous measurement or load shedding, as in the classical setup. Instead, the grid is made stable by discretely...... relocating the equilibrium point and its stability region, such that the system is consecutively attracted from the fault-cleared state back to the original equilibrium point. The proposed control is designed by solving linear and convex optimization problems, making it possibly scalable to large-scale power...

  7. Emerging arboviruses: Why today?

    Directory of Open Access Journals (Sweden)

    Ernest Gould

    2017-12-01

    Full Text Available The recent global (reemergence of arthropod-borne viruses (arboviruses, such as chikungunya and Zika virus, was widely reported in the media as though it was a new phenomenon. This is not the case. Arboviruses and other human microbial pathogens have been (reemerging for centuries. The major difference today is that arbovirus emergence and dispersion are more rapid and geographically extensive, largely due to intensive growth of global transportation systems, arthropod adaptation to increasing urbanisation, our failure to contain mosquito population density increases and land perturbation. Here we select examples of (reemerging pathogenic arboviruses and explain the reasons for their emergence and different patterns of dispersal, focusing particularly on the mosquito vectors which are important determinants of arbovirus emergence. We also attempt to identify arboviruses likely to (reemerge in the future.

  8. Feline ocular emergencies.

    Science.gov (United States)

    Giuliano, Elizabeth A

    2005-05-01

    Feline ocular emergencies include any ophthalmic condition that has rapidly developed or is the result of trauma to the eye or periocular structures. Common feline emergencies include proptosis, lid lacerations, corneal ulcers, and foreign bodies. Complete ophthalmic examination including procurement of the minimal ophthalmic database (Schirmer tear test, fluorescein stain, and intraocular pressure measurement) should be obtained whenever possible to ensure that the complete and correct diagnosis is made. Concern for the patient's vision and ocular comfort should guide the practioner's diagnostic and therapeutic plan. This article reviews some of the more common feline ocular emergencies, including conditions affecting the orbit and globe, adnexa, conjunctiva, and cornea. Feline uveitis, glaucoma, and lenticular diseases are covered more thoroughly elsewhere in this issue.

  9. 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.

  10. Characterization of radiological emergencies

    Energy Technology Data Exchange (ETDEWEB)

    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/sup 0/C to -20/sup 0/C, 100% relative humidity, 60-cm-high obstacles, stairs, airlocks, darkness, and lack of electric power.

  11. Emerging Biomaterials in Trauma.

    Science.gov (United States)

    Zakhary, Kirollos E; Thakker, Jayini S

    2017-02-01

    Emerging technologies and research into the science of biomaterials have developed exponentially and provide facial reconstructive surgeons with a plethora of options for a multitude of varying presentations. This article presents a comprehensive discussion in the ever-evolving field of material science and emerging biomaterials. A complete understanding of the current status of such materials is necessary for the appropriate incorporation and applicability to adequate clinical situations. The rapid progress seen in biomaterials is evidenced through the forward direction of bioengineered tissues, the incorporation of growth factors in varying scenarios, and the unique characteristics of 3-D printing of patient specific scaffolds. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Update on emergency contraception.

    Science.gov (United States)

    Fine, Paul M

    2011-02-01

    Emergency contraception is a woman's last chance to prevent unintended pregnancy. Ulipristal acetate, a selective progesterone receptor modulator, when taken as a single 30 mg dose, is a new, safe and effective emergency contraceptive that can be used from the first day and up to 5 days following unprotected intercourse. The older progesterone-only emergency contraceptive, levonorgestrel, is taken as two 0.75 mg pills 12 hours apart (Next Choice(®); Watson Pharmaceuticals Inc., Morristown, NJ, USA) or a single 1.5 mg pill (Plan B One-Step™; Watson Pharmaceuticals Inc.), and is approved for only 72 hours after unprotected intercourse. During clinical development, ulipristal acetate has been shown to be more effective than levonorgestrel in delaying or inhibiting ovulation. A recent meta-analysis of two randomized clinical trials showed ulipristal acetate to have a pregnancy risk 42% lower than levonorgestrel up to 72 hours and 65% lower in the first 24 hours following unprotected intercourse. Moreover, when taken beyond 72 hours, significantly more pregnancies were prevented with ulipristal acetate than with levonorgestrel. Side effects are mild and similar to those seen with levonorgestrel. Ulipristal acetate was approved for emergency contraception by the US Food and Drug Administration in August 2010, and has been launched in the USA as ella(®) (Watson Pharmaceuticals Inc.) since December 1, 2010. Ella is prescription only and is priced comparable to Plan B One-Step.

  13. Emergence and Evolution

    DEFF Research Database (Denmark)

    Bullwinkle, Tammy J; Ibba, Michael

    2013-01-01

    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...

  14. about Emergency Contraception?

    African Journals Online (AJOL)

    Abstract. Currently, emergency contraception is seldom used in Kenya. As part of a larger study designed to provide in- sight into the possible roles for the method in Kenya, we assessed the knowledge of and attitudes towards emer- gency contraception in two groups of potential users, and we focus on these data ...

  15. 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…

  16. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger

    2008-01-01

    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  17. Emergency Heart Valve Replacement

    Science.gov (United States)

    Stinson, Edward B.; Shumway, Norman E.

    1968-01-01

    Sixteen patients with terminal cardiac failure due to valvular heart disease had emergency operation for value replacement. Four patients did not survive, because of irreversible myocardial or secondary organ involvement. The remainder, however, had immediate reversal of heart failure after operation, and all became fully active following discharge. Recognition of refractory decompensation in valvular heart disease demands prompt consideration of surgical intervention. PMID:5724875

  18. Emerging multiethnolects in Europe

    NARCIS (Netherlands)

    Nortier, J.M.|info:eu-repo/dai/nl/074734644; Adger, David; Cheshire, Jenny

    2015-01-01

    We discuss the results of research carried out in the last ten years or so in Scandinavia, the Netherlands, Germany, France and the UK, on new forms and styles of language that have emerged in multilingual areas of European cities. We discuss the problematic nature of the term multiethnolect, and

  19. Himalaya: Emergence and Evolution

    Indian Academy of Sciences (India)

    Himalaya: Emergence and Evolution. Rasoul Sorkhabi. Book Review Volume 8 Issue 6 June 2003 pp 80-81. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/008/06/0080-0081. Author Affiliations. Rasoul Sorkhabi1. Senior Geologist, Japan National Oil Corporation, Japan.

  20. Emergency Response Alternatives

    Science.gov (United States)

    Based on the National Contingency Plan, EPA defines the following types: classic emergencies, requiring on-site activities within minutes/hours; time-critical actions, which must occur within 6 months; and non-time-critical actions, which can take longer.

  1. Synopsis of emergent approaches

    Science.gov (United States)

    Malcolm North; Brandon Collins; John Keane; Jonathan W. Long; Carl Skinner; Bill. Zielinski

    2014-01-01

    This synopsis presents three integrated themes that emerged from synthesizing information about biological resources. These themes become particularly important when managing forests to promote resilience at large landscape scales and long timeframes. This synopsis summarizes ideas in the longer chapter 1.2, “Integrative Approaches: Promoting Socioecological Resilience...

  2. 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)

  3. Fire Department Emergency Response

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A. [Westinghouse Savannah River Company, AIKEN, SC (United States); 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.

  4. 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......-seeking investments and relate them to the contributions in the current special issue. We conclude with outlining an agenda of future research....

  5. 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 ...

  6. Emergency medicine: beyond the basics.

    Science.gov (United States)

    Malamed, S F

    1997-07-01

    Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate management of two common emergency situations: allergy and chest pain.

  7. 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…

  8. Emergent Use-Patterns

    DEFF Research Database (Denmark)

    2002-01-01

    When a networked organisation chooses to invest a considerable amount of esources in deploying a groupware application the reasons and goals can vary. No matter why the groupware was initially deployed it is in general very difficult to monitor and evaluate how it is actually used and integrated...... with the work practice. This research-in-progress investigates the possibilities of evaluating the integration by characterising emergent use-patterns. We have studied the deployment and use of a generic web based groupware application – Lotus QuickPlace (QP) – in a large networked organisation distributed...... throughout Scandinavia and elsewhere. We have employed a research method comprising different data-gathering techniques – interview, participant observation, document analysis, survey, and http-log analysis – in an attempt to analyse how the groupware is used and which general use-patterns emerge after...

  9. 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.

  10. [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.

  11. Transfusion Related Emergencies

    Directory of Open Access Journals (Sweden)

    Megan Boysen Osborn

    2016-09-01

    Full Text Available 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 with patients, as well as manage the associated complications of blood transfusion. Objectives: At the end of this didactic session, the learner will be able to: 1 list the various transfusion reactions and their approximate incidence; 2 understand the pathophysiology behind each transfusion reaction; 3 describe the management for each type of transfusion reaction; and 4 discuss the plan for prevention of future transfusion reactions. Method: This is a classic team based learning exercise (cTBL.

  12. Centromere Emergence in Evolution

    OpenAIRE

    Ventura, Mario; Archidiacono, Nicoletta; Rocchi, Mariano

    2001-01-01

    Evolutionary centromere repositioning is a paradox we have recently discovered while studying the conservation of the phylogenetic chromosome IX in primates. Two explanations were proposed: a conservative hypothesis assuming sequential pericentric inversions, and a more challenging assumption involving centromere emergence during evolution. The complex evolutionary history showed by chromosome IX did not allow us to clearly distinguish between these two hypotheses. Here we report comparative ...

  13. Architecture humanitarian emergencies

    DEFF Research Database (Denmark)

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

    2013-01-01

    of architecture. Followed by articles focusing on interdisciplinary research and design of emergency shelters as well as educational environments. Finally concretized in 35 studies from international workshops arranged globally on and by different architect schools: Royal Danish Academy of Fine Arts in Denmark......, 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....

  14. 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.

  15. Emergency Response Guideline Development

    Energy Technology Data Exchange (ETDEWEB)

    Gary D. Storrick

    2007-09-30

    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&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.

  16. Emergency contraception: a review.

    Science.gov (United States)

    Corbelli, J; Bimla Schwarz, E

    2014-12-01

    Emergency contraceptives (EC) are forms of contraception that women can use after intercourse to prevent pregnancy. EC use is safe for women of all ages, and there are no medical contraindications to its use. There are two types of emergency contraceptive pills currently available: ulipristal acetate (UPA) and levonorgestrel. UPA is the most effective oral option for EC. In the United States, levonorgestrel containing ECPs are available without prescription to women and men without age restrictions. However, the more effective UPA pills require a prescription. ECPs do not cause abortion or harm an established pregnancy. Placement of a copper intrauterine device (IUD) is more effective EC than either UPA or levonorgestrel, and requires a timely visit with a trained clinician. EC pills are less effective for women who are overweight or obese, therefore such women should be offered a copper IUD or ulipristal rather than levonorgestrel pills. Any woman requesting EC after unprotected intercourse should be offered treatment within 120 hours of intercourse, as should all women who are victims of sexual assault. Women requesting EC should be offered information and services for ongoing contraception. Although levonorgestrel EC is now available over-the-counter, ongoing need exists to educate women about emergency contraception to encourage prompt use of EC when it is needed.

  17. Anaesthesia for vascular emergencies.

    Science.gov (United States)

    Ellard, L; Djaiani, G

    2013-01-01

    Patients presenting with vascular emergencies including acute aortic syndrome, ruptured thoracic or abdominal aortic aneurysms, thoracic aortic trauma and acute lower limb ischaemia have a high risk of peri-operative morbidity and mortality. Although anatomical suitability is not universal, endovascular surgery may improve mortality and the results of ongoing randomised controlled trials are awaited. Permissive hypotension pre-operatively should be the standard of care with the systolic blood pressure kept to 50-100 mmHg as long as consciousness is maintained. The benefit of local anaesthesia over general anaesthesia is not definitive and this decision should be tailored for a given patient and circumstance. Cerebrospinal fluid drainage for prevention of paraplegia is often impractical in the emergency setting and is not backed by strong evidence; however, it should be considered postoperatively if symptoms develop. We discuss the pertinent anaesthetic issues when a patient presents with a vascular emergency and the impact that endovascular repair has on anaesthetic management. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

  18. Cockpit emergency safety system

    Science.gov (United States)

    Keller, Leo

    2000-06-01

    A comprehensive safety concept is proposed for aircraft's experiencing an incident to the development of fire and smoke in the cockpit. Fire or excessive heat development caused by malfunctioning electrical appliance may produce toxic smoke, may reduce the clear vision to the instrument panel and may cause health-critical respiration conditions. Immediate reaction of the crew, safe respiration conditions and a clear undisturbed view to critical flight information data can be assumed to be the prerequisites for a safe emergency landing. The personal safety equipment of the aircraft has to be effective in supporting the crew to divert the aircraft to an alternate airport in the shortest possible amount of time. Many other elements in the cause-and-effect context of the emergence of fire, such as fire prevention, fire detection, the fire extinguishing concept, systematic redundancy, the wiring concept, the design of the power supplying system and concise emergency checklist procedures are briefly reviewed, because only a comprehensive and complete approach will avoid fatal accidents of complex aircraft in the future.

  19. Footprints of Emergence

    Directory of Open Access Journals (Sweden)

    Roy Trevor Williams

    2012-10-01

    Full Text Available It is ironic that the management of education has become more closed while learning has become more open, particularly over the past 10-20 years. The curriculum has become more instrumental, predictive, standardized, and micro-managed in the belief that this supports employability as well as the management of educational processes, resources, and value. Meanwhile, people have embraced interactive, participatory, collaborative, and innovative networks for living and learning. To respond to these challenges, we need to develop practical tools to help us describe these new forms of learning which are multivariate, self-organised, complex, adaptive, and unpredictable. We draw on complexity theory and our experience as researchers, designers, and participants in open and interactive learning to go beyond conventional approaches. We develop a 3D model of landscapes of learning for exploring the relationship between prescribed and emergent learning in any given curriculum. We do this by repeatedly testing our descriptive landscapes (or footprints against theory, research, and practice across a range of case studies. By doing this, we have not only come up with a practical tool which can be used by curriculum designers, but also realised that the curriculum itself can usefully be treated as emergent, depending on the dynamics between prescribed and emergent learning and how the learning landscape is curated.

  20. Dermatopathologic emergencies part I

    Directory of Open Access Journals (Sweden)

    Douglas Hoffman Atmatzidis

    2017-01-01

    Full Text Available In dermatopathology, there are several conditions which must be addressed emergently. While some conditions necessitate emergent intervention because of the pathology of the cutaneous manifestations, others require recognition of the underlying serious systemic conditions represented by the cutaneous signs and symptoms. We describe the desquamating disorders (Staphylococcal scalded skin syndrome, Stevens–Johnson syndrome/toxic epidermal necrolysis, and edema-related desquamation, erythema multiforme, cutaneous aspergillosis, tinea/Candida overlying fractures, rickettsial infections, and eczema herpeticum as diseases which should be addressed immediately upon presentation because of the seriousness and rapidity of progression of their pathology. Moreover, porphyria cutanea tarda, Birt-Hogg-Dubé syndrome, Muir-Torre syndrome, and acquired ochronosis may exemplify conditions where the cutaneous signs serve as warnings for severe systemic disease that may not be emergencies in isolation, but can indicate rapid occult development of destructive and sometimes deadly noncutaneous pathology. The literature review was conducted using searches in Pubmed and references to textbooks on the subjects.

  1. 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.

  2. Copeptin for risk stratification in non-traumatic headache in the emergency setting: a prospective multicenter observational cohort study.

    Science.gov (United States)

    Blum, Claudine Angela; Winzeler, Bettina; Nigro, Nicole; Schuetz, Philipp; Biethahn, Silke; Kahles, Timo; Mueller, Cornelia; Timper, Katharina; Haaf, Katharina; Tepperberg, Janina; Amort, Margareth; Huber, Andreas; Bingisser, Roland; Sándor, Peter Stephan; Nedeltchev, Krassen; Müller, Beat; Katan, Mira; Christ-Crain, Mirjam

    2017-12-01

    In the emergency setting, non-traumatic headache is a benign symptom in 80% of cases, but serious underlying conditions need to be ruled out. Copeptin improves risk stratification in several acute diseases. Herein, we investigated the value of copeptin to discriminate between serious secondary headache and benign headache forms in the emergency setting. Patients presenting with acute non-traumatic headache were prospectively enrolled into an observational cohort study. Copeptin was measured upon presentation to the emergency department. Primary endpoint was serious secondary headache defined by a neurologic cause requiring immediate treatment of the underlying disease. Secondary endpoint was the combination of mortality and hospitalization within 3 months. Two board-certified neurologist blinded to copeptin levels verified the endpoints after a structured 3-month-telephone interview. Of the 391 patients included, 75 (19%) had a serious secondary headache. Copeptin was associated with serious secondary headache (OR 2.03, 95%CI 1.52-2.70, p copeptin to identify the primary endpoint was 0.70 (0.63-0.76). After adjusting for age > 50, focal-neurological abnormalities, and thunderclap onset of symptoms, copeptin remained an independent predictive factor for serious secondary headache (OR 1.74, 95%CI 1.26-2.39, p = 0.001). Moreover, copeptin improved the AUC of the multivariate logistic clinical model (p-LR-test copeptin values were higher in patients reaching the secondary endpoint, this association was not significant in multivariate logistic regression. Copeptin was independently associated with serious secondary headache as compared to benign headaches forms. Copeptin may be a promising novel blood biomarker that should be further validated to rule out serious secondary headache in the emergency department. Study Registration on 08/02/2010 as NCT01174901 at clinicaltrials.gov.

  3. 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 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...

  4. 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

  5. Emergence of Life.

    Science.gov (United States)

    Bassez, Marie-Paule

    2011-09-29

    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 transformation of molecules, of

  6. Emerging Multinationals: Multilatinas

    Directory of Open Access Journals (Sweden)

    Jose Satsumi Lopez-Morales

    2014-04-01

    Full Text Available The aim of this paper is to analyze the origin and conceptualization of “multilatinas” and some particular features, for which it is conducted a review of the literature related to the conceptualization of these topics. Next, it is presented the historical development of the internationalization process in Latin America , some particular features of emerging multinationals and “multilatinas”. Likewise, it is presented some particular features of state “multilatinas” and non-traditional “multilatinas”. Finally, it is presented some conclusions and some gaps in the literature.

  7. Human Freedom ``Emergence''

    Science.gov (United States)

    Newsome, William T.

    Whether free will is a reality is an increasingly urgent problem, both from a scientific and a social point of view. An ability to make judgments and take actions that are "free" in some meaningful sense would seem a prerequisite for the process of scientific reasoning and for our ability to behave morally. How are we to reconcile the "autonomy" of a reasoning intellect with our scientific conviction that all behavior is mediated by mechanistic interactions between cells of the central nervous system? It seems that answers will ultimately lie in a deeper understanding of emergent phenomena in complex systems. This will help enrich our impoverished standard notions of causation in physical systems.

  8. Ocular Emergencies: Red Eye.

    Science.gov (United States)

    Tarff, Andreina; Behrens, Ashley

    2017-05-01

    "Red eye" is used as a general term to describe irritated or bloodshot eyes. It is a recognizable sign of an acute/chronic, localized/systemic underlying inflammatory condition. Conjunctival injection is most commonly caused by dryness, allergy, visual fatigue, contact lens overwear, and local infections. In some instances, red eye can represent a true ocular emergency that should be treated by an ophthalmologist. A comprehensive assessment of red eye conditions is required to preserve the patients visual function. Severe ocular pain, significant photophobia, decreased vision, and history of ocular trauma are warning signs demanding immediate ophthalmological consultation. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Earthquakes and emergence

    Science.gov (United States)

    Earthquakes and emerging infections may not have a direct cause and effect relationship like tax evasion and jail, but new evidence suggests that there may be a link between the two human health hazards. Various media accounts have cited a massive 1993 earthquake in Maharashtra as a potential catalyst of the recent outbreak of plague in India that has claimed more than 50 lives and alarmed the world. The hypothesis is that the earthquake may have uprooted underground rat populations that carry the fleas infected with the bacterium that causes bubonic plague and can lead to the pneumonic form of the disease that is spread through the air.

  10. 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......, networks, labour market pooling and specialised suppliers). However, these factors are not sufficient to explain the early formation of clusters. The dominant theories focus more on explaining ex-post dynamics than their early development. This chapter focuses on the early phase and uses an alternative...

  11. Build an Emergency Preparedness Kit

    Science.gov (United States)

    Build an emergency preparedness kit Disasters can occur quickly and without warning. Assemble a kit designed to help you cope with a variety of emergencies. Items for your kit: -First aid kit, essential ...

  12. Emergency planning for industrial hazards

    Energy Technology Data Exchange (ETDEWEB)

    Gow, H.B.F.; Kay, R.W. (eds.)

    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 organisation 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.

  13. Imaging of nontraumatic thoracic emergencies

    NARCIS (Netherlands)

    Stoger, L.; Schaefer-Prokop, C.M.; Geurts, B.H.J.

    2017-01-01

    PURPOSE OF REVIEW: Acute chest symptoms form an important incentive for imaging in the emergency setting. This review discusses the radiologic features of various vascular and pulmonary diseases leading to acute respiratory distress and recent developments on important emergency radiologic

  14. Ideas Production in Emerging Economies

    OpenAIRE

    Luintel, Kul B.; KHAN, 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.

  15. Emergent behaviors of classifier systems

    Energy Technology Data Exchange (ETDEWEB)

    Forrest, S.; Miller, J.H.

    1989-01-01

    This paper discusses some examples of emergent behavior in classifier systems, describes some recently developed methods for studying them based on dynamical systems theory, and presents some initial results produced by the methodology. The goal of this work is to find techniques for noticing when interesting emergent behaviors of classifier systems emerge, to study how such behaviors might emerge over time, and make suggestions for designing classifier systems that exhibit preferred behaviors. 20 refs., 1 fig.

  16. The Neurobiology of Anesthetic Emergence.

    Science.gov (United States)

    Tarnal, Vijay; Vlisides, Phillip E; Mashour, George A

    2016-07-01

    Achieving a smooth and rapid emergence from general anesthesia is of particular importance for neurosurgical patients and is a clinical goal for neuroanesthesiologists. Recent data suggest that the process of emergence is not simply the mirror image of induction, but rather controlled by distinct neural circuits. In this narrative review, we discuss (1) hysteresis, (2) the concept of neural inertia, (3) the asymmetry between the neurobiology of induction and emergence, and (4) recent attempts at actively inducing emergence.

  17. 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.

  18. 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.

  19. Seizures: emergency neuroimaging.

    Science.gov (United States)

    Hess, Christopher P; Barkovich, A James

    2010-11-01

    The various findings observed on computed tomography (CT) and magnetic resonance (MR) imaging examinations in patients with seizures reflect the variety of different causes that give rise to this common neurologic symptom. In the emergency setting, CT is most valuable in its ability to accurately identify acute abnormalities that require emergent medical or surgical treatment. MR imaging, by contrast, is usually reserved for patients with recurrent or refractory seizures. The accurate interpretation of either modality requires familiarity with how seizures are classified clinically, the most common presenting features of different causes for seizures, the relevant neuroanatomy, and the imaging manifestations of both common and uncommon causes of seizures and epilepsy. Of particular practical importance to the radiologist is the ability to recognize (1) the most common findings in patients with recurrent seizures and (2) potentially reversible causes for seizures that require prompt intervention to avoid or minimize permanent brain injury. This article surveys a variety of different causes for seizures and epilepsy, focusing on specific clinical features that can help to refine differential diagnosis, and on imaging findings characteristic of different disorders. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. Emergent complex network geometry.

    Science.gov (United States)

    Wu, Zhihao; Menichetti, Giulia; Rahmede, Christoph; Bianconi, Ginestra

    2015-05-18

    Networks are mathematical structures that are universally used to describe a large variety of complex systems such as the brain or the Internet. Characterizing the geometrical properties of these networks has become increasingly relevant for routing problems, inference and data mining. In real growing networks, topological, structural and geometrical properties emerge spontaneously from their dynamical rules. Nevertheless we still miss a model in which networks develop an emergent complex geometry. Here we show that a single two parameter network model, the growing geometrical network, can generate complex network geometries with non-trivial distribution of curvatures, combining exponential growth and small-world properties with finite spectral dimensionality. In one limit, the non-equilibrium dynamical rules of these networks can generate scale-free networks with clustering and communities, in another limit planar random geometries with non-trivial modularity. Finally we find that these properties of the geometrical growing networks are present in a large set of real networks describing biological, social and technological systems.

  1. Hypertensive emergencies in children.

    Science.gov (United States)

    Hari, Pankaj; Sinha, Aditi

    2011-05-01

    Hypertensive emergencies, though uncommon in children, are potentially life threatening. While targeting blood pressure reduction to below the 90th percentile for age, gender and height, mean arterial blood pressure should be gradually lowered by one-fourth of the planned reduction over 8-12 h, a further fourth over the next 8-12 h, and the final 50% over the 24 h after that. Frequent invasive or non-invasive blood pressure monitoring is essential, as is monitoring for sensorial alteration and loss of papillary reflexes. Few antihypertensive agents have been examined in children. Continuous intravenous infusions of short acting drugs such as nitroprusside, labetalol and nicardipine are preferred to intravenous boluses of hydralazine or diazoxide. If severe symptoms are absent, oral agents such as nifedipine, clonidine, minoxidil, hydralazine, labetalol, captopril, and prazosin may be used. Nicardipine and labetalol are particularly suited in emergencies with intracranial bleeding or ischemic stroke, while furosemide, sodium nitroprusside and nitroglycerine are useful in congestive cardiac failure. Therapy with oral antihypertensive drugs should be instituted within 6-12 h of parenteral therapy, and the latter gradually withdrawn over the next 12-48 h. Oral agents have limited application as primary therapy, except when administration of intravenous infusion is likely to be delayed. This article provides a summary of the clinical approach to evaluation and management of severe symptomatic hypertension in children.

  2. Emergency Exercise Participation and Evaluation

    Science.gov (United States)

    Smith, Julie; Black, Lynette; Williams, Linda

    2012-01-01

    Extension is uniquely positioned to participate in emergency exercises, formally or informally, with the goal of engaging community members in emergency and disaster preparedness. With their knowledge of community needs, Extension personnel are valuable resources and can assist emergency managers in the process of identifying local risks and…

  3. Emerging Adulthood: Resilience and Support

    Science.gov (United States)

    Hinton, Vanessa; Meyer, Jill

    2014-01-01

    Purpose: This article provides an overview of emerging adulthood, recentering, and resilience of youth with disabilities. Emerging adulthood is a developmental period during which individuals experience delays in attainment of adult roles and social expectations. Recentering is a process that emerging adults experience as they make distinct shifts…

  4. 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.

  5. 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.

  6. [Electrolyte metabolism and emergency].

    Science.gov (United States)

    Nakao, I; Ito, T; Kasai, N

    1983-02-01

    In outlining the pathology of various electrolyte metabolism abnormalities in cancer patients we considered the main clinical points between pathologies and emergency treatment. In regard to sodium (Na+) metabolism, one pathologic state that requires our attention is hypernatremia. Hypernatremia is accompanied with dehydration and is due to water loss, vomiting, diarrhea and renal insufficiency. One of the major causes of this condition is lack of the antidiuretic hormone due to intracranial metastasis of the tumor. When hypernatremia becomes severe, it is accompanied with circulatory failure, muscular asthenia, disorientation, convulsions, coma and other cerebral symptoms. Treatment consists of replenishing the water content by infusion of electrolyte solutions which should be carefully conducted after complete diagnose of the severity of the patient's pathological condition. Hyponatremia, like sick cell syndrome, is observed relatively frequently in cancer patients. When the serum Na level falls markedly, it induces cerebral edema and causes disorders of consciousness. The major treatment consists of providing both water and sodium supplements. Hyperkalemia is observed at the time of renal insufficiency, tissue lesions, vomiting, and diarrhea. When serum potassium level rises, it causes bradycardia, ventricular fibrillation, or cardiac arrest. It is important to diagnostically apprehend the severity of this condition using EKG and determining the serum K1+ level. For emergency treatment injection of calcium gluconate is very effective. Hypokalemia is often manifested by the loss of intestinal fluids due to diarrhea or during administration of diuretic agents. Clinical symptoms include neural paralysis but emergencies occur relatively infrequently. K C1 injections are used in treating this condition. Hypercalcemia is manifested in cancer patients during hyperparathyroidism. Its clinical symptoms include lassitude, tachycardia, nausea, vomiting, and renal dys

  7. 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.

  8. Emergency medicine in Southern Brazil.

    Science.gov (United States)

    Tannebaum, R D; Arnold, J L; De Negri Filho, A; Spadoni, V S

    2001-02-01

    Emergency medicine is developing rapidly in southern Brazil, where elements of both the Franco-German and the Anglo-American models of emergency care are in place, creating a uniquely Brazilian approach to emergency care. Although emergency medical services (EMS) in Brazil have been directly influenced by the French mobile EMS (SAMU) system, with physicians dispatched by ambulances to the scenes of medical emergencies, the first American-style emergency medicine residency training program in Brazil was recently established at the Hospital de Pronto Socorro (HPS) in Porto Alegre. Emergency trauma care appears to be particularly developed in southern Brazil, where advanced trauma life support is widely taught and SAMU delivers sophisticated trauma care en route to trauma centers designated by the state.

  9. Virtue in emergency medicine.

    Science.gov (United States)

    Larkin, Gregory Luke; Iserson, Kenneth; Kassutto, Zach; Freas, Glenn; Delaney, Kathy; Krimm, John; Schmidt, Terri; Simon, Jeremy; Calkins, Anne; Adams, James

    2009-01-01

    At a time in which the integrity of the medical profession is perceptibly challenged, emergency physicians (EPs) have an opportunity to reaffirm their commitment to both their patients and their practice through acceptance of a virtue-based ethic. The virtue-based ethic transcends legalistic rule following and the blind application of principles. Instead, virtue honors the humanity of patients and the high standards of the profession. Recognizing historical roots that are relevant to the modern context, this article describes 10 core virtues important for EPs. In addition to the long-recognized virtues of prudence, courage, temperance, and justice, 6 additional virtues are offered unconditional positive regard, charity, compassion, trustworthiness, vigilance, and agility. These virtues might serve as ideals to which all EPs can strive. Through these, the honor of the profession will be maintained, the trust of patients will be preserved, and the integrity of the specialty will be promoted.

  10. Emerging Targets in Photopharmacology.

    Science.gov (United States)

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

    2016-09-05

    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 provides a viable alternative to optogenetics. We present here a critical overview of the different pharmacological targets in various organs and a survey of organ systems in the human body that can be addressed in a non-invasive manner. We discuss the prospects for the selective delivery of light to these organs and the specific requirements for light-activatable drugs. We also aim to illustrate the druggability of medicinal targets with recent findings and emphasize where conceptually new approaches have to be explored to provide photopharmacology with future opportunities to bring "smart" molecular design ultimately to the realm of clinical use. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Adjusting to the Emergent

    DEFF Research Database (Denmark)

    Revsbæk, Line

    In her doctoral thesis Line Revsbæk explores newcomer innovation related to organizational entry processes in a changing organization. She introduces process philosophy and complexity theory to research on organizational socialization and newcomer innovation. The study challenges assumptions......’ of newcomers enacting the organizational emergent. The study throws light on the informal socialization in work-related interactions between newcomers and veterans and reveals professional relational histories, as well as the relationship between veteran coworker and hiring manager, to be important aspects...... in standardized induction programs where newcomers are cast in roles as insecure novices needing to be “taught the ropes” of the organizational culture. Linked with this, it is suggested that the prevailing dichotomy of ‘newcomer assimilation’ versus ‘organizational accommodation’ is replaced with a notion...

  12. Emerging molecular cytogenetic technologies.

    Science.gov (United States)

    Chang, S S; Mark, H F

    1997-01-01

    Fluorescent in situ hybridization (FISH) as an adjunct technique to conventional banding techniques has been firmly established in the past few years. The many clinical and research applications of FISH include chromosome enumeration using alpha-satellite probes, marker identification, gene mapping and 'chromosome painting' in the delineation of complex structural chromosomal abnormalities. Comparative genomic hybridization (CGH) is a relatively new FISH-based technique which can detect gains and losses of whole chromosomes and subchromosomal regions. Like CGH, which can scan the whole genome without prior knowledge of specific chromosomal abnormalities, spectral karyotyping (SKY) confers on each chromosome a distinct colour to enable identification of even cryptic chromosomal rearrangements. The present paper introduces and summarizes these emerging molecular cytogenetic techniques.

  13. Emergency department seizure epidemiology.

    Science.gov (United States)

    Martindale, Jennifer L; Goldstein, Joshua N; Pallin, Daniel J

    2011-02-01

    Although only 3% of people in the United States are diagnosed with epilepsy, 11% will have at least one seizure during their lifetime. Seizures account for about 1% of all emergency department (ED) visits, and about 2% of visits to children's hospital EDs. Seizure accounts for about 3% of prehospital transports. In adult ED patients, common causes of seizure are alcoholism, stroke, tumor, trauma, and central nervous system infection. In children, febrile seizures are most common. In infants younger than 6 months, hyponatremia and infection are important considerations. Epilepsy is an uncommon cause of seizures in the ED, accounting for a minority of seizure-related visits. Of ED patients with seizure, about 7% have status epilepticus, which has an age-dependent mortality averaging 22%. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. 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.

  15. 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...

  16. Adjusting to the Emergent

    DEFF Research Database (Denmark)

    Revsbæk, Line

    of ‘adjusting to the emergent’. Newcomer innovation is portrayed as carrying a variety of possible significations, such as unintentional innovation effects of newcomer’s proactive self-socializing behavior; an inspirational basis for designing innovation-generating employee induction; ‘resonant instances......In her doctoral thesis Line Revsbaek explores newcomer innovation related to organizational entry processes in a changing organization. She introduces process philosophy and complexity theory to research on organizational socialization and newcomer innovation. The study challenges assumptions......’ of newcomers enacting the organizational emergent. The study throws light on the informal socialization in work-related interactions between newcomers and veterans and reveals professional relational histories, as well as the relationship between veteran coworker and hiring manager, to be important aspects...

  17. Emerging therapies for gout.

    Science.gov (United States)

    Edwards, N Lawrence; So, Alexander

    2014-05-01

    Over the past decade much has been learned about the mechanisms of crystal-induced inflammation and renal excretion of uric acid, which has led to more specific targeting of gout therapies and a more potent approach to future management of gout. This article outlines agents being developed for more aggressive lowering of urate and more specific anti-inflammatory activity. The emerging urate-lowering therapies include lesinurad, arhalofenate, ulodesine, and levotofisopam. Novel gout-specific anti-inflammatories include the interleukin-1β inhibitors anakinra, canakinumab, and rilonacept, the melanocortins, and caspase inhibitors. The historic shortcomings of current gout treatment may, in part, be overcome by these novel approaches. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. 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.

  19. Emergency interventions for hyperkalaemia.

    Science.gov (United States)

    Mahoney, B A; Smith, W A D; Lo, D S; Tsoi, K; Tonelli, M; Clase, C M

    2005-04-18

    Hyperkalaemia occurs in outpatients and in between 1% and 10% of hospitalised patients. When severe, consequences include arrhythmia and death. To review randomised evidence informing the emergency (i.e. acute, rather than chronic) management of hyperkalaemia We searched MEDLINE (1966-2003), EMBASE (1980-2003), The Cochrane Library (issue 4, 2003), and SciSearch using the text words hyperkal* or hyperpotass* (* indicates truncation). We also searched selected journals and abstracts of meetings. The reference lists of recent review articles, textbooks, and relevant papers were reviewed for additional potentially relevant titles. All selection was performed in duplicate. Articles were considered relevant if they were randomised, quasi-randomised or cross-over randomised studies of pharmacological or other interventions to treat non-neonatal humans with hyperkalaemia, reporting on clinically-important outcomes, or serum potassium levels within the first six hours of administration. All data extraction was performed in duplicate. We extracted quality information, and details of the patient population, intervention, baseline and follow-up potassium values. We extracted information about arrhythmias, mortality and adverse effects. Where possible, meta-analysis was performed using random effects models. None of the studies of clinically-relevant hyperkalaemia reported mortality or cardiac arrhythmias. Reports focussed on serum potassium levels. Many studies were small, and not all intervention groups had sufficient data for meta-analysis to be performed. On the basis of small studies, inhaled beta-agonists, nebulised beta-agonists, and intravenous (IV) insulin-and-glucose were all effective, and the combination of nebulised beta agonists with IV insulin-and-glucose was more effective than either alone. Dialysis is effective. Results were equivocal for IV bicarbonate. K-absorbing resin was not effective by four hours, and longer follow up data on this intervention were not

  20. 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

  1. 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...

  2. 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.

  3. The scientific production of Brazilian neurologists: 1995-2004.

    Science.gov (United States)

    Nitrini, Ricardo

    2006-06-01

    The Brazilian scientific production saw more than a four-fold increase from the 1990s onwards. The aim of this study was to evaluate the evolution of scientific production by Brazilian clinical neuroscientists over the last 10 years. A search in the PubMed identified 295 clinical neuroscientists and their publications. Brazilian production corresponded to 2.37% of the papers published by the 20 indexed periodicals that regularly publish clinical neuroscience research. If only the first and last two years are compared, there was a real growth of 75.1%. More than 40% of the Brazilian papers were published in Arquivos de Neuro-Psiquiatria, the official journal of the Brazilian Academy of Neurology. When only those periodicals with impact factor higher than one are considered, the percentage falls to 0.86% in the whole 10-year period, but attains 1.23% in 2004. Epilepsy and infectious diseases were the sub-areas with the highest scientific production.

  4. 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.

  5. [Psychiatric emergencies in drug addiction].

    Science.gov (United States)

    Benyamina, Amine; Bouchez, Jacques; Rahioui, Hassan; Reynaud, Michel

    2003-06-01

    The practitioner is very frequently confronted by emergencies in drug-addicted patients also having psychiatric symptomatology. In this article the authors will address emergencies related to alcohol (notably intoxication, pre-DTs and the encephalopathies); emergencies related to cannabis (notably intoxication, psychotic states and panic attacks); and emergencies related to other psycho-active substances (overdoses, drug-withdrawal, psychiatric complications related to cocaine or amphetamines). In the domain of drug addiction, as in psychiatry, the practitioner must give as much importance to the organisation of the long-term healthcare plan for the drug addict, ulterior to the management of the immediate emergency. For example, whereas 90% of subjects presenting to the emergency department for acute alcoholic intoxication have a pathological consumption of alcohol (abuse or dependance), management of the alcoholism is proposed in only 2% of them.

  6. 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

  7. Consciousness: Emergent and Real

    Directory of Open Access Journals (Sweden)

    Reza Maleeh

    2015-12-01

    Full Text Available In this paper, we propose three lines of argumentation against Nannini’s eliminativist approach towards consciousness and the Self. First, we argue that the premises he uses to argue for eliminativism can equally well be used to draw a completely different conclusion in favor of naturalistic dualism according to which phenomenal consciousness irreducibly emerges from a physical substrate by virtue of certain psychophysical laws of nature. Nannini proposes that in contrast to dualistic theses which represent the manifest image of the world, eliminativism represents the world’s scientific image just as classical physics and theories of relativity respectively represent the world’s manifest image and scientific image. And if developments in a scientific field reveal a conflict between these two images we should always vote for the scientific image. In our second line of argument, we challenge this claim by comparing two rival interpretations of quantum mechanics, i.e. the Copenhagen and Bohmian interpretation of quantum mechanics. Finally, we argue that Nannini’s identification of consciousness and the Self as illusions does not shed any light on the hard problem of consciousness since illusions themselves are instances of phenomenal experiences and need to be explained.

  8. Emerging Biomarkers in Glioblastoma

    Directory of Open Access Journals (Sweden)

    Warren P. Mason

    2013-08-01

    Full Text Available Glioblastoma, the most common primary brain tumor, has few available therapies providing significant improvement in survival. Molecular signatures associated with tumor aggressiveness as well as with disease progression and their relation to differences in signaling pathways implicated in gliomagenesis have recently been described. A number of biomarkers which have potential in diagnosis, prognosis and prediction of response to therapy have been identified and along with imaging modalities could contribute to the clinical management of GBM. Molecular biomarkers including O(6-methlyguanine-DNA-methyltransferase (MGMT promoter and deoxyribonucleic acid (DNA methylation, loss of heterozygosity (LOH of chromosomes 1p and 19q, loss of heterozygosity 10q, isocitrate dehydrogenase (IDH mutations, epidermal growth factor receptor (EGFR, epidermal growth factor, latrophilin, and 7 transmembrane domain-containing protein 1 on chromosome 1 (ELTD1, vascular endothelial growth factor (VEGF, tumor suppressor protein p53, phosphatase and tensin homolog (PTEN, p16INK4a gene, cytochrome c oxidase (CcO, phospholipid metabolites, telomerase messenger expression (hTERT messenger ribonucleic acid [mRNA], microRNAs (miRNAs, cancer stem cell markers and imaging modalities as potential biomarkers are discussed. Inclusion of emerging biomarkers in prospective clinical trials is warranted in an effort for more effective personalized therapy in the future.

  9. Emerging Biomarkers in Glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    McNamara, Mairéad G.; Sahebjam, Solmaz; Mason, Warren P., E-mail: warren.mason@uhn.ca [Pencer Brain Tumor Centre, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada)

    2013-08-22

    Glioblastoma, the most common primary brain tumor, has few available therapies providing significant improvement in survival. Molecular signatures associated with tumor aggressiveness as well as with disease progression and their relation to differences in signaling pathways implicated in gliomagenesis have recently been described. A number of biomarkers which have potential in diagnosis, prognosis and prediction of response to therapy have been identified and along with imaging modalities could contribute to the clinical management of GBM. Molecular biomarkers including O(6)-methlyguanine-DNA-methyltransferase (MGMT) promoter and deoxyribonucleic acid (DNA) methylation, loss of heterozygosity (LOH) of chromosomes 1p and 19q, loss of heterozygosity 10q, isocitrate dehydrogenase (IDH) mutations, epidermal growth factor receptor (EGFR), epidermal growth factor, latrophilin, and 7 transmembrane domain-containing protein 1 on chromosome 1 (ELTD1), vascular endothelial growth factor (VEGF), tumor suppressor protein p53, phosphatase and tensin homolog (PTEN), p16INK4a gene, cytochrome c oxidase (CcO), phospholipid metabolites, telomerase messenger expression (hTERT messenger ribonucleic acid [mRNA]), microRNAs (miRNAs), cancer stem cell markers and imaging modalities as potential biomarkers are discussed. Inclusion of emerging biomarkers in prospective clinical trials is warranted in an effort for more effective personalized therapy in the future.

  10. Emerging Biomarkers in Cognition

    Science.gov (United States)

    Wicklund, Meredith; Petersen, Ronald C.

    2014-01-01

    Synopsis The field of aging and dementia is rapidly evolving with the aim of identifying individuals in the earliest stages of disease processes. Biomarkers allow the clinician to demonstrate the presence of an underlying pathologic process and resultant synapse dysfunction and neurodegeneration, even in those earliest stages. For example, PET amyloid imaging and CSF Aβ42 provide direct evidence of amyloid deposition and structural MRI, FDG-PET or SPECT and CSF tau provide indirect evidence of synapse dysfunction and neurodegeneration when the pathologic process is due to Alzheimer's disease (AD). While this review will focus on biomarkers for mild cognitive impairment (MCI) due to AD, structural MRI, FDG-PET or SPECT, and PET with dopamine ligands are also valuable in suggesting non-AD pathologic processes. While these biomarkers are very useful and can even be applied to diagnostic criteria in MCI, several limitations exist. As the field continues to grow, several new biomarkers are emerging and ultimately, a more biological characterization of subjects’ underlying pathophysiologic spectra will be possible. PMID:24094298

  11. Emerging Vaccine Informatics

    Science.gov (United States)

    He, Yongqun; Rappuoli, Rino; De Groot, Anne S.; Chen, Robert T.

    2010-01-01

    Vaccine informatics is an emerging research area that focuses on development and applications of bioinformatics methods that can be used to facilitate every aspect of the preclinical, clinical, and postlicensure vaccine enterprises. Many immunoinformatics algorithms and resources have been developed to predict T- and B-cell immune epitopes for epitope vaccine development and protective immunity analysis. Vaccine protein candidates are predictable in silico from genome sequences using reverse vaccinology. Systematic transcriptomics and proteomics gene expression analyses facilitate rational vaccine design and identification of gene responses that are correlates of protection in vivo. Mathematical simulations have been used to model host-pathogen interactions and improve vaccine production and vaccination protocols. Computational methods have also been used for development of immunization registries or immunization information systems, assessment of vaccine safety and efficacy, and immunization modeling. Computational literature mining and databases effectively process, mine, and store large amounts of vaccine literature and data. Vaccine Ontology (VO) has been initiated to integrate various vaccine data and support automated reasoning. PMID:21772787

  12. Emerging optical nanoscopy techniques

    Science.gov (United States)

    Montgomery, Paul C; Leong-Hoi, Audrey

    2015-01-01

    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. PMID:26491270

  13. [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.

  14. Putting experimental dynamics into the field: the German 'Ostfeldzug' and the creation of emergency care chains in military neurology and neurological surgery, 1941-1945.

    Science.gov (United States)

    Stahnisch, Frank W

    2014-01-01

    The interconnections between the history of neurology and neurological surgery with the development of modern, technological warfare are a vastly under-researched area of medical history. The main objectives of this paper are hence to contribute to the understanding and analysis of a major case example from World War II. The article's research is based on work at the Bundesarchiv in Koblenz, the Max Planck Gesellschaft in Berlin, and literature regarding the Fuehrungsstab der Luftwaffe, undertaken as part of a larger scale project on the history of the neurosciences and psychiatry in the first half of the 20th century. The current article focuses particularly on the Ostfeldzug of the Wehrmacht and the creation of emergency care chains in military neurology and neurological surgery. Its results show how major German neurologists, such as Otfrid Foerster, Wilhelm Toennis, Georg Merrem and Klaus Joachim Zuelch have contributed to the development of emergency care chains in military neurology. Key Messages: In conclusion, despite the atrocities and often-inhumane ways through which knowledge was gathered in contemporary military neurology, a better understanding of modern neurology can be gained from a critical assessment of the history of military neurology during World War II. © 2014 S. Karger AG, Basel.

  15. Schwarzschild instanton in emergent gravity

    Science.gov (United States)

    Chanda, Sumanto; Guha, Partha; Roychowdhury, Raju

    2017-09-01

    In the bottom-up approach of emergent gravity, we attempt to find symplectic gauge fields emerging from Euclidean Schwarzschild instanton, which is studied as electromagnetism defined on the symplectic space (M,ω). Geometrical engineering with the emergent metric sets up the Seiberg-Witten map between commutative and non-commutative gauge fields, preparing the ground for the evaluation of topological invariants in terms of the underlying gauge theory quantities.

  16. Reforming Disaster and Emergency Response

    Science.gov (United States)

    2011-03-24

    St ra te gy R es ea rc h Pr oj ec t REFORMING DISASTER AND EMERGENCY RESPONSE BY COLONEL MARK D. JOHNSON United States Army...From - To) 4. TITLE AND SUBTITLE Reforming Disaster and Emergency Response 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...the Federal Emergency Management Agency (FEMA) has focused too much on day- to-day disasters , from snow storms to forest fires, tripling the number

  17. 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.

  18. 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.

  19. 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...

  20. 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...

  1. An update on emergency care and emergency medicine in Russia.

    Science.gov (United States)

    Rodigin, Anthony

    2015-12-01

    Russia's national healthcare system is undergoing significant changes. Those changes which affect healthcare financing are particularly vital. As has often been the case in other nations, the emergency care field is at the forefront of such reforms. The ongoing challenges constitute the environment in which the hospital-based specialty of emergency medicine needs to develop as part of a larger system. Emergency care has to evolve in order to match true needs of the population existing today. New federal regulations recently adopted have recognized emergency departments as the new in-hospital component of emergency care, providing the long-needed legal foundation upon which the new specialty can advance. General knowledge of Western-style emergency departments in terms of their basic setup and function has been widespread among Russia's medical professionals for some time. Several emergency departments are functioning in select regions as pilots. Preliminary data stemming from their operation have supported a positive effect on efficiency of hospital bed utilization and on appropriate use of specialists and specialized hospital departments. In the pre-hospital domain, there has been a reduction of specialized ambulance types and of the number of physicians staffing all ambulances in favor of midlevel providers. Still, a debate continues at all levels of the medical hierarchy regarding the correct future path for emergency care in Russia with regard to adaptation and sustainability of any foreign models in the context of the country's unique national features.

  2. Advanced practice registered nurses: Addressing emerging needs in emergency care

    Directory of Open Access Journals (Sweden)

    Rachel L. DiFazio

    2014-03-01

    Full Text Available An advanced practice registered nurse (APRN is a registered nurse with advanced specialized clinical knowledge and skills to provide healthcare to diverse populations. The role of the APRN is emerging worldwide to improve access to, quality, and cost-effective healthcare services. APRNs with expanded capabilities are now working in a variety of healthcare settings including emergency centres. This paper will provide a brief overview of APRN roles in the United States followed by a discussion of how APRNs can meet the healthcare needs of patients seeking emergency care. An example from a paediatric specialty practice will demonstrate how the APRN role can be implemented in the emergency centre. Finally, implications for initiating APRNs in emergency care across Africa will be addressed.

  3. 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.

  4. [Guideline on the use of corticosteroids in Duchenne muscular dystrophy from paediatric neurologists, neurologists and rehabilitation physicians

    NARCIS (Netherlands)

    Groot, I.J.M. de

    2006-01-01

    A guideline on the treatment of boys with muscular dystrophy with corticosteroids has been written and is available from the Dutch patients' organization. The guideline has been approved by the Dutch Societies of Neurology, Rehabilitation and Paediatrics. Based on the available literature the advice

  5. 44 CFR 206.225 - Emergency work.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Emergency work. 206.225 Section 206.225 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... Emergency work. (a) General. (1) Emergency protective measures to save lives, to protect public health and...

  6. Purposeful authoring for emergent narrative

    NARCIS (Netherlands)

    Louchart, Sandy; Swartjes, I.M.T.; Kriegel, Michael; Aylett, Ruth

    2008-01-01

    Emergent narrative (EN) is a narrative concept in virtual reality that relies on emergence for a flexible shaping of stories as opposed to fixed pre-determined plots. This has consequences for the creative role of the author in an EN system. In this paper, we aim to clarify the actual function of

  7. 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...

  8. 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....

  9. Monitoring new and emerging risks

    NARCIS (Netherlands)

    Houtman, I.L.D.; Douwes, M.; Zondervan, E.; Jongen, M.

    2014-01-01

    This article, based on recent literature, will identify, define and discuss new and emerging OSH-risks together with the driving forces behind these risks. Emerging risks will be described as being related to physical load and musculoskeletal disorders [MSDs], psychosocial risks, and dangerous

  10. Emergency departments in The Netherlands.

    NARCIS (Netherlands)

    Thijssen, W.A.M.H.; Giesen, P.H.J.; Wensing, M.J.

    2012-01-01

    Emergency medicine in The Netherlands is faced with an increasing interest by politicians and stakeholders in health care. This is due to crowding, increasing costs, criticism of the quality of emergency care, restructuring of out-of-hours services in primary care and the introduction of a training

  11. Modernizing emergency alerts poses challenges

    OpenAIRE

    Center for Homeland Defense and Security

    2010-01-01

    Center for Homeland Defense and Security, OUT OF THE CLASSROOM Download the paper: Paper: IPAWS (Integrated Public Alert and Warning System)” Modernizing emergency alerts poses challenges Anthony Cox is interested in the next generation of emergency alert systems.Any television viewer...

  12. 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.

  13. 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.

  14. 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

  15. Client counseling in orthopedic emergencies.

    Science.gov (United States)

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

    1995-09-01

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

  16. 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.

  17. 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.

  18. Wildlife Emergency and Critical Care.

    Science.gov (United States)

    Riley, Jennifer; Barron, Heather

    2016-05-01

    Wildlife patients often present as emergencies. For veterinarians who do not typically treat wildlife, it is important to be able to stabilize and determine the underlying cause of the animal's signs. This article discusses initial assessment, stabilization, and treatment of common emergency presentations in wild birds, reptiles, and mammals. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Cognitive Radio for Emergency Networks

    NARCIS (Netherlands)

    Zhang, Q.; Kokkeler, Andre B.J.; Smit, Gerardus Johannes Maria

    2006-01-01

    In the scope of the Adaptive Ad-hoc Freeband (AAF) project, an emergency network built on top of Cognitive Radio is proposed to alleviate the spectrum shortage problem which is the major limitation for emergency networks. Cognitive Radio has been proposed as a promising technology to solve

  20. Emergency Vehicle Siren Noise Effectiveness

    Science.gov (United States)

    D'Angela, Peter

    Navigating safely through traffic, while responding to an emergency, is often a challenge for emergency responders. To help alert other motorists, these responders use emergency lights and/or sirens. However, the former is useful only if within clear visual range of the other drivers. This shortcoming puts a greater emphasis on the importance of the audible emergency siren, which has its own shortcomings. This study considered several emergency siren systems with the goal to determine the most effective siren system(s) based on several criteria. Multiple experimental measurements and subjective analysis using jury testing using an NVH driving simulator were performed. It was found that the traditional mechanical siren was the most effective audible warning device; however, with significantly reduced electrical power requirements, the low frequency Rumbler siren, in conjunction with a more conventional electronic Yelp siren, was the preferred option. Recommendations for future work are also given.

  1. Emergency thoracotomies: Two center study

    Directory of Open Access Journals (Sweden)

    Sameh Ibrahim Sersar

    2013-01-01

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

  2. Emergent Entities and Emergent Processes: Constructing Emergence through Multi-Agent Programming.

    Science.gov (United States)

    Wilensky, Uri

    The use of programming language was studied in an eighth grade science classroom. The goal of the EMERGE curriculum is to enable students to understand the global patterns that they observe. EMERGE was used in an eighth-grade classroom of 12 students, with a range of abilities (3 had learning disabilities), in 21 sessions over 3 months. For the…

  3. The Re-Emergence of the Emergence Debate

    Directory of Open Access Journals (Sweden)

    Sami Pihlström

    2002-06-01

    Full Text Available This essay provides a critical review of contemporary controversies related to the notion of emergence by discussing, among other recent views, Achim Stephan's defense of the ontological tradition of emergentist thought along the lines of C. D. Broad Stephan's distinctions between various notions of emergence, different in strength, are useful as they clarify the state of discussion. There are, however, several unsettled problems concerning emergence. Some of these (e. g., downward causation have been dealt with by Stephan, Kim, and others, though not entirely satisfactorily, while others (e. g., the nature of properties, the issue of realism would require further investigation in this context. It is argued in particular that downward causation would not trouble emergentists, were they willing to adopt a more Kantian and/or Wittgenstenian approach. Some examples of such an option are given. Thus, the article sketches a philosophical perspective from which a radical reassessment of the emergence debate could be pursued.

  4. 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.

  5. 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.

  6. 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...

  7. Emergency management: An annotated bibliography

    Energy Technology Data Exchange (ETDEWEB)

    1988-03-01

    Training Resources and Data Exchange (TRADE) is an organization designed to increase communication and exchange of ideas, information, and resources among US Department of Energy contractors and DOE personnel. Oak Ridge Associated Universities, located in Oak Ridge, Tennessee, manages TRADE for the DOE. The Emergency Preparedness Special Interest Group (EP SIG) is a group formed within TRADE for emergency preparedness coordinators and trainers to share information about emergency preparedness training and other EP resources. This bibliography was prepared for the EP SIG as a resource for EP training and planning activities.

  8. 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...... care in real time. Today only an early prototype of 3DMC exists. To better understand 3DMC's potential for adoption and use in emergency healthcare before large amounts of development resources are invested we conducted a visioning study. That is, we shared our vision of 3DMC with emergency room...

  9. Common Emergencies in Pet Birds.

    Science.gov (United States)

    Stout, Jane D

    2016-05-01

    Treating avian emergencies can be a challenging task. Pet birds often mask signs of illness until they are critically ill and require quick initiation of supportive care with minimal handling to stabilize them. This article introduces the clinician to common avian emergency presentations and details initial therapeutics and diagnostics that can be readily performed in the small-animal emergency room. Common disease presentations covered include respiratory and extrarespiratory causes of dyspnea, gastrointestinal signs, reproductive disease, neurologic disorders, trauma, and toxin exposure. The duration and severity of the avian patient's disease and the clinician's initiation of appropriate therapy often determines clinical outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. 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...

  11. 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.

  12. 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.

  13. [Invasive emergency techniques (INTECH). A training concept in emergency medicine].

    Science.gov (United States)

    Zink, W; Völkl, A; Martin, E; Gries, A

    2002-10-01

    Introducing a chest tube is a routine emergency procedure in trauma victims. Emergency coniotomy or establishing an intraosseous access, however, are not often necessary, but in individual cases these techniques can be decisive for patient survival. The aim of this study was to present and evaluate a model for teaching these techniques, since the majority of emergency physicians do not have adequate experience in this area. In November 2001 our institution organized the first workshop on "Invasive emergency techniques (INTECH): chest tube, emergency coniotomy, and intraosseous access" in collaboration with the Institute of Anatomy II of the University of Heidelberg. After presenting basic anatomy and also particular features of the relevant regions of the body, the techniques of introducing a thoracic drainage, performing a coniotomy, and establishing an intraosseous access were presented. Video demonstrations as well as practical exercises on corpses followed the theoretical part of the course. At the end of each lesson, the participants were asked anonymously why they took part in the workshop and about their previous experience with these emergency techniques in written form and also asked to assess the didactic concept of the workshop (scale 1=very good up to 6=very poor). Of the 86 participants, 66 completed the questionnaire (77%) and 40 of the participants had been working as emergency physicians for 6.5+/-6.3 years (range 0.5-22) with approx. 13+/-8 (range 4-30) interventions per month. The most common reason for participating was lack of practice (52%): prior to the workshop, 98% of the emergency physicians had never performed a coniotomy, 85% had never established an intraosseous access, and 28% had never introduced a chest tube in an emergency setting. The theoretical parts of the course received the following scores: "Basic anatomy" 2.3+/-0.8, "coniotomy" 1.7+/-0.7, "intraosseous access" 1.5+/-0.5, and "thoracic drainage " 1.7+/-0.7. In the practical

  14. [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.

  15. 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...

  16. Opioid Considerations for Emergency Practice

    Directory of Open Access Journals (Sweden)

    Thomas Terndrup

    2015-12-01

    Full Text Available On a backdrop of increasingly distressing opioid misuse in our communities, and safety concerns expressed by The Joint Commission and others, emergency physicians are further increasing their utilization of these important agents in our patients.

  17. Emergency Response and Management Activities

    Science.gov (United States)

    This quarterly report, highlighting accomplishments over the past several months, showcases EPA’s unique emergency response capabilities through the use of cutting-edge technologies and innovative cleanup strategies.

  18. Evaluation of emergency department performance

    DEFF Research Database (Denmark)

    Sørup, Christian Michel; Jacobsen, Peter; Forberg, Jakob Lundager

    2013-01-01

    Background Evaluation of emergency department (ED) performance remains a difficult task due to the lack of consensus on performance measures that reflects high quality, efficiency, and sustainability. Aim To describe, map, and critically evaluate which performance measures that the published...

  19. 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.

  20. Forum outlines top emerging technologies

    Science.gov (United States)

    Extance, Andy

    2015-04-01

    Additive manufacturing, next-generation robotics, "sense and avoid" drones that fly themselves, artificial intelligence and "neuromorphic" computing have all made it into the World Economic Forum's top 10 emerging technologies for 2015.

  1. Responding to a Choking Emergency

    Science.gov (United States)

    ... Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & ... Find a Pediatrician Health Issues Conditions Injuries & Emergencies Sports Injuries Vaccine Preventable Diseases Healthy Children > Health Issues > ...

  2. 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...

  3. Burnout syndrome in emergency medicine

    National Research Council Canada - National Science Library

    Ivanić, Dubravka; Adam, Višnja Nesek; Srzić, Ivana; Stepić, Anika; Pintarić, Hrvoje

    2017-01-01

    ... the individual’s performance, thus being a major factor that influences the quality of work. Objectives: The aim of the study was to assess the existence of burnout syndrome in medical staff working at hospital emergency department...

  4. Energy Emergency and Contingency Planning

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Region 3 document outlines the purpose of Energy Emergency and Contingency Plans. These plans are intended to help refuges continue to function during energy...

  5. RMA Emergency Management / Contingency Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The RMA Emergency Management/Contingency Plan (EM/CP) provides guidance to the Rocky Mountain Arsenal (RMA) and the RMA National Wildlife Refuge (RMANWR) managers...

  6. Emergency Preparedness and Response Systems

    National Research Council Canada - National Science Library

    Alvarez, Maria D

    2006-01-01

    .... Natural and man-made disasters, such as earthquakes, floods, plane crashes, high-rise building collapses, or major nuclear facility malfunctions, pose an ever-present danger challenge to public emergency services...

  7. 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)

  8. 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...

  9. Leadership and the emergency department.

    Science.gov (United States)

    LaSalle, Gar

    2004-02-01

    Emergency medicine, as the nation's health care system's safety net, is facing ever increasing demands on its resources and infrastructure. Classic and modern theories of leadership, which include broader based models that in corporate team responsibilities, should be studied by anyone wearing the mantle of leadership in emergency medicine, and the Realpolitik of the modern hospital must be accommodated if leadership efforts are to succeed.

  10. 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......-learning can increase the learning effect. We developed an emergency ultrasound app to enable onsite e-learning for trainees. In this paper, we share our experiences in the development of this app and present the final product....

  11. The Emergence of Latin Multinationals

    OpenAIRE

    Santiso, Javier

    2008-01-01

    The corporate world has changed remarkably in the past 10 years. New multinationals are appearing in countries with emerging markets such as Brazil, India, China, South Africa and Mexico, which are not only top recipients of foreign capital, but have fast become major investors themselves. An important part of the remarkable story of emerging multinationals has been the eruption of world-class Latin multinationals (or multilatinas) from Mexico and Brazil, in particular, foll...

  12. Emergency care for potbellied pigs.

    Science.gov (United States)

    Tynes, V V

    1998-09-01

    Because of the limited number of veterinarians treating potbellied pigs, many pet pigs do not receive proper preventative health care. The potbellied pig's continued popularity among urban dwellers ensures that veterinarians who treat small and exotic animals will be contacted by owners of pet pigs with real or perceived emergencies. Regardless of their knowledge of swine, the information contained in this article should enable any veterinarian to provide basic emergency care for pet pigs.

  13. 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.

  14. [Informed consent in emergency medicine].

    Science.gov (United States)

    Ersoy, Nermin; Ozcan Senses, Müesser; Aydin Er, Rahime

    2010-01-01

    Informed consent is a prerequisite for the ethical and legal validity of the emergency intervention in emergency medicine, since it protects the fiduciary relationship between the physician and patient; the principle of honesty that grounds this relationship; the principle of autonomy that necessitates right of self-determination; and the principle of respect for persons. Informed consent in emergency medicine, which is supposed to include the nature, benefits and risks of emergency medical intervention, differentiates with respect to definite groups of patients: (1) conscious patients, (2) unconscious patients, and (3) children and mature minors. In addition, informed consent differentiates between medical, psychological and even social circumstances of the patients, referred to as valid consent, expressed-explicit consent, blanket consent, presumed consent, tacit consent, proxy consent, and parental consent. There are a few exceptions in which emergency medical intervention is administered without informed consent. In addition to the exceptions of life-saving interventions, when a patient can not decide for herself/himself, intervention of the physician in the best interest of the patient or children is based on the "therapeutic privilege" of the physician. As an ethically defensible right, since therapeutic privilege may open a door to hard paternalistic approaches, in those situations, emergency physicians should be cautious not to violate a patient's autonomy.

  15. 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.

  16. 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.

  17. 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

  18. Rural Emergency Medical Services (EMS) and Trauma

    Science.gov (United States)

    ... Rural Health Topics & States Topics View more Rural Emergency Medical Services (EMS) and Trauma Emergency medical services ( ... related deaths and nonfatal injuries treated in rural emergency departments? According to a Centers for Disease Control ...

  19. 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 ...

  20. 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...

  1. Ulipristal acetate for emergency contraception.

    Science.gov (United States)

    Russo, J A; Creinin, M D

    2010-09-01

    Ulipristal acetate is a progesterone receptor modulator. As an emergency contraceptive, a 30-mg micronized formulation is effective for use up to 120 h from unprotected sexual intercourse. Ulipristal acetate acts as an antagonist of the progesterone receptor at the transcriptional level and a competitive antagonist of glucocorticoid receptor function. In contrast to other contraceptives, it has little effect on sex hormone-binding globulin. Although a single small study demonstrated some potential endometrial effects after ulipristal acetate administration, the clinical relevance of these findings is unclear. The incidence of adverse events in clinical trials for emergency contraception has typically been minimal, with one study showing a higher than expected incidence of nausea upon ulipristal acetate use. Ulipristal acetate, like other emergency contraceptive products, can lengthen the time to the next expected menstruation. Ulipristal acetate may have several advantages over currently approved emergency contraceptives. When compared to levonorgestrel, ulipristal acetate maintains its efficacy for a full 120 h, whereas levonorgestrel formulations have declining efficacy over that time frame. Moreover, although the copper intrauterine device (IUD) is highly effective as an emergency contraceptive, accessibility is an issue since the IUD requires a skilled provider for insertion. Copyright 2010 Prous Science, S.A.U. or its licensors. All rights reserved.

  2. 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.

  3. Laparoscopic approach in gastrointestinal emergencies.

    Science.gov (United States)

    Jimenez Rodriguez, Rosa M; Segura-Sampedro, Juan José; Flores-Cortés, Mercedes; López-Bernal, Francisco; Martín, Cristobalina; Diaz, Verónica Pino; Ciuro, Felipe Pareja; Ruiz, Javier Padillo

    2016-03-07

    This review focuses on the laparoscopic approach to gastrointestinal emergencies and its more recent indications. Laparoscopic surgery has a specific place in elective procedures, but that does not apply in emergency situations. In specific emergencies, there is a huge range of indications and different techniques to apply, and not all of them are equally settle. We consider that the most controversial points in minimally invasive procedures are indications in emergency situations due to technical difficulties. Some pathologies, such as oesophageal emergencies, obstruction due to colon cancer, abdominal hernias or incarcerated postsurgical hernias, are nearly always resolved by conventional surgery, that is, an open approach due to limited intraabdominal cavity space or due to the vulnerability of the bowel. These technical problems have been solved in many diseases, such as for perforated peptic ulcer or acute appendectomy for which a laparoscopic approach has become a well-known and globally supported procedure. On the other hand, endoscopic procedures have acquired further indications, relegating surgical solutions to a second place; this happens in cholangitis or pancreatic abscess drainage. This endoluminal approach avoids the need for laparoscopic development in these diseases. Nevertheless, new instruments and new technologies could extend the laparoscopic approach to a broader array of potentials procedures. There remains, however, a long way to go.

  4. 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.

  5. 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.

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

    Science.gov (United States)

    Hawkes, Maximiliano A; Farez, Mauricio F; Calandri, Ismael L; Ameriso, Sebastián F

    2016-11-01

    Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. 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 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.

  7. 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...

  8. Conscientious objection and emergency contraception.

    Science.gov (United States)

    Card, Robert F

    2007-06-01

    This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to be equivalent to abortion or because they believe contraception itself is immoral. This article critically evaluates these reasons and concludes that they do not successfully support conscientious objection in this context. Contrary to the views of other thinkers, it is not possible to easily strike a respectful balance between the interests of objecting providers and patients in this case. As medical professionals, providers have an ethical duty to inform women of this option and provide emergency contraception when this treatment is requested.

  9. Emergent Universe with particle production

    CERN Document Server

    Gangopadhyay, Sunandan; Mukherjee, S

    2014-01-01

    The possibility of an emergent universe solution to Einstein's field equations allowing for an irreversible creation of matter at the expense of the gravitational field is shown. With the universe being chosen as spatially flat FRW spacetime together with equation of state proposed in [17], the solution exists when the ratio of the phenomenological matter creation rate to the number density times the Hubble parameter is a number $\\beta$ of the order of unity and independent of time. The thermodynamic behaviour is also determined for this solution. Interestingly, we also find that an emergent universe scenario is present with usual equation of state in cosmology when the matter creation rate is chosen to be a constant. More general class of emergent universe solutions are also discussed.

  10. 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.

  11. 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...... failures. Design/methodology/approach: Theory on organizational change is applied to capture the processes leading to emergence of city logistics. The methodology is process analysis on a single longitudinal case. Findings: The emergence of the Copenhagen city logistics project can be understood....... The study aims at understanding the social processes towards reduced congestion and greenhouse gas emissions from goods transport in inner cities. Originality/value: By better understanding the organization processes leading to implementation of city logistics, other projects in other cities may learn from...

  12. 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...

  13. 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.

  14. Review of Spaceflight Dental Emergencies

    Science.gov (United States)

    Menon, Anil

    2012-01-01

    All exploration class missions--extending beyond earth's orbit--differ from existing orbital missions by being of longer duration and often not having a means of evacuation. If an exploration mission extends beyond a year, then there will be a greater lapse since the crewmembers last terrestrial dental exams, which routinely occur each year. This increased time since professional dental care could increase the chance of a dental emergency such as intractable pain, dental decay requiring a temporary filling, crown replacement, exposed pulp, abscess, tooth avulsion, or toothache. Additionally, any dental emergency will have to be treated in-flight with available resources and personnel who may not have extensive training in dental care. Thus, dental emergencies are an important risk to assess in preparation for exploration missions.

  15. Emergent universe from noncommutative spacetime

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jungjai [Daejin University, Pocheon (Korea, Republic of); Yang, Hyunseok [Ewha Womans University, Seoul (Korea, Republic of)

    2010-09-15

    The Big Bang, which was the birth of our Universe, happened at the Planck epoch. It was not an event that developed in a pre-existing space-time. Rather, it was a cosmological event simultaneously generating space-time as well as all other matter fields. Therefore, in order to describe the origin of our Universe, it is necessary to have a background-independent theory for quantum gravity in which no space-time structure is a priori assumed, but is defined from the theory. The emergent gravity based on noncommutative gauge theory provides such a background-independent formulation of quantum gravity, and the emergent space-time leads to a novel picture of the dynamical origin of space-time. We address some issues about the origin of our Universe and discuss the implications to cosmology of the emergent gravity.

  16. Emergence: complexity pedagogy in action.

    Science.gov (United States)

    Jonas-Simpson, Christine; Mitchell, Gail; Cross, Nadine

    2015-01-01

    Many educators are looking for new ways to engage students and each other in order to enrich curriculum and the teaching-learning process. We describe an example of how we enacted teaching-learning approaches through the insights of complexity thinking, an approach that supports the emergence of new possibilities for teaching-learning in the classroom and online. Our story begins with an occasion to meet with 10 nursing colleagues in a three-hour workshop using four activities that engaged learning about complexity thinking and pedagogy. Guiding concepts for the collaborative workshop were nonlinearity, distributed decision-making, divergent thinking, self-organization, emergence, and creative exploration. The workshop approach considered critical questions to spark our collective inquiry. We asked, "What is emergent learning?" and "How do we, as educators and learners, engage a community so that new learning surfaces?" We integrated the arts, creative play, and perturbations within a complexity approach.

  17. Experiences of Emerging Economy Firms

    DEFF Research Database (Denmark)

    Vissak, Tiia; Zhang, Xiaotian

    2015-01-01

    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...... and experience the impact of home institutions and government policies. This ground breaking and illuminating title presents issues of theoretical and practical significance, thus challenging existing paradigms of firm internationalization....

  18. Contemporary imaging in abdominal emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Sivit, Carlos J. [Rainbow Babies and Children' s Hospital, Case Western Reserve School of Medicine, Department of Radiology, Cleveland, OH (United States)

    2008-11-15

    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.)

  19. [Congenital syphilis: an emerging emergency also in Brazil

    Science.gov (United States)

    Lago, E G; Garcia, P C

    2000-01-01

    OBJECTIVE: To highlight to the fact that some newborns are not identified as having congenital syphilis, and will present to an emergency room within a few months with a severe disease. METHOD: Review of the charts concerning 3 patients with congenital syphilis, as well as review of the literature using Medline and Lilacs databases, covering the period from 1988 to 1999. RESULTS: We describe the case of 3 infants whose diagnosis of congenital syphilis was only established after the neonatal period, when they presented to the emergency room and were admitted to the pediatric intensive care unit. The first patient had neurosyphilis and nephrotic syndrome, the second had neurosyphilis, and the third had hepatitis. We discuss the clinical aspects of the cases, and comment on other clinical manifestations of congenital syphilis that should be within the purview of pediatric emergency medicine. We analyze the reasons for the failure to diagnose syphilis at birth, and describe some risk factors for gestational syphilis. CONCLUSIONS: Considering the rising incidence of syphilis in Brazil, and the possibility that the congenital infections are not recognized at birth, emergency physicians must keep a high degree of suspicion and an awareness of maternal risk factors, prenatal serology pitfalls, as well as of the several clinical presentations of congenital syphilis that can develop in the first months of life.

  20. Open Standards for Emergency Mangement

    Science.gov (United States)

    Jones, E.

    2012-04-01

    The mission of the OASIS (Organization for the Advancement of Structured Information Standards) Emergency Management Technical Committee (EM-TC) is to create incident and emergency-related standards for data interoperability. The TC welcomes participation from members of the emergency management community, developers and implementers, and members of the public concerned with disaster management and response. Since the foundation of the EM-TC in 2003, there have been several Standards developed to support this mission. The first and most widely accepted has been the Common Alerting Protocol (CAP). CAP has been adopted worldwide and is also ITU Recommendation 1303. The EM-TC has continued in the development of content data standards to support the emergency management mission. This suite of standards is referred to as the Emergency Data Exchange Language (EDXL) family of standards. The EDXL suite of standards are developed starting with a defined requirement from the response community. The requirements are vetted through a working group process, reviewed by the development community to determine whether the concepts once "standardized" will result in software that will be developed then provided with comments to the OASIS EM-TC for defining the standard. The OASIS process includes an open public review period where all comments are accepted and publically adjudicated. The EDXL-Distribution Element (DE), EDXL-Resource Management (RM), EDXL-Hospital Availability eXchange (HAVE) are all now ratified Standards. The EDXL-Situation Reporting (SitRep) Standard is in final review and the EXDL-Tracking of Emergency Patients (TEP) is in development. This presentation will briefly present each of the OASIS EM-TC Standards as well as the process for their development and review. Information will be provided about how to participate in the process as well as where open source code can be found to get started developing systems of systems using the EDXL Standards.

  1. Emerging infectious diseases in wildlife.

    Science.gov (United States)

    Williams, E S; Yuill, T; Artois, M; Fischer, J; Haigh, S A

    2002-04-01

    The processes which give rise to emerging infectious diseases of wildlife can be categorised as follows: ecosystem alterations of anthropogenic or natural origin; movement of pathogens or vectors, via human or natural agency; and changes in microbes or in the recognition of emerging pathogens due to advances in the techniques of epidemiology. These are simplistic divisions because factors influencing the emergence of diseases of wild animals generally fall into more than one category. Mycoplasmosis among passerines is related to habitat changes and artificial feeding resulting in increased bird densities and subsequent disease transmission. The origin of this strain of Mycoplasma gallisepticum is not known. Hantavirus infections in rodents have emerged due to human-induced landscape alterations and/or climatic changes influencing population dynamics of hantavirus reservoir hosts, with disease consequences for humans. Movement of pathogens or vectors is a very important process by which diseases of wildlife expand geographic range. Although the origin of caliciviruses of rabbits and hares is somewhat obscure, their movement by humans, either deliberately or accidentally, has greatly expanded the distribution of these viruses. Rabies is an ancient disease, but geographic expansion has occurred by both natural and anthropogenic movements of wild animals. Human movement of amphibians may explain the distribution of the highly pathogenic chytrid fungus around the world. Newly recognised paramyxoviruses may reflect both changes in these pathogens and the development of techniques of identification and classification. Many more such examples of emerging diseases will arise in the future, given the extensive alterations in landscapes world-wide and movements of animals, vectors and pathogens. Those who study and diagnose diseases of wildlife must be alert for emerging diseases so that the impact of such diseases on wild animals, domestic animals and humans can be minimised.

  2. The Emergency Landing Planner Experiment

    Science.gov (United States)

    Meuleau, Nocolas F.; Neukom, Christian; Plaunt, Christian John; Smith, David E.; Smith, Tristan B.

    2011-01-01

    In previous work, we described an Emergency Landing Planner (ELP) designed to assist pilots in choosing the best emergency landing site when damage or failures occur in an aircraft. In this paper, we briefly describe the system, but focus on the integration of this system into the cockpit of a 6 DOF full-motion simulator and a study designed to evaluate the ELP. We discuss the results of this study, the lessons learned, and some of the issues involved in advancing this work further.

  3. Awareness during emergence from anaesthesia

    DEFF Research Database (Denmark)

    Thomsen, J. L.; Nielsen, C V; Eskildsen, K Z

    2015-01-01

    BACKGROUND: Butyrylcholinesterase deficiency can result in prolonged paralysis after administration of succinylcholine or mivacurium. We conducted an interview study to assess whether patients with butyrylcholinesterase deficiency were more likely to have experienced awareness during emergence from...... were eligible to be interviewed. Of the 70 patients interviewed, 35 (50%) were aware while paralysed during emergence. Of these, 28 (80%) were not monitored with a nerve stimulator when awakened, compared with 17 (49%) of the 35 unaware patients (P=0.012, Fisher's exact test). Thirty (86%) aware...... patients reported distress compared with seven (20%) unaware patients (Pemergence...

  4. 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...... safe and tolerable. The determination of which incretin-based therapy to choose necessitates comparisons between the various GLP-1R agonists. The available GLP-1R agonists cause sustained weight loss and clinical relevant improvement of glycemic control. The long-acting GLP-1R agonists in late...

  5. Wilderness Emergency Medical Services Systems.

    Science.gov (United States)

    Millin, Michael G; Hawkins, Seth C

    2017-05-01

    Wilderness emergency medical services (WEMS) are designed to provide high quality health care in wilderness environments. A WEMS program should have oversight by a qualified physician responsible for protocol development, education, and quality improvement. The director is also ideally fully trained as a member of that wilderness rescue program, supporting the team with real-time patient care. WEMS providers function with scopes of practice approved by the local medical director and regulatory authority. With a focus on providing quality patient care, it is time for the evolution of WEMS as an integrated element of a local emergency response system. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Regular nanofabrics in emerging technologies

    CERN Document Server

    Jamaa, M Haykel Ben

    2011-01-01

    ""Regular Nanofabrics in Emerging Technologies"" gives a deep insight into both fabrication and design aspects of emerging semiconductor technologies, that represent potential candidates for the post-CMOS era. Its approach is unique, across different fields, and it offers a synergetic view for a public of different communities ranging from technologists, to circuit designers, and computer scientists. The book presents two technologies as potential candidates for future semiconductor devices and systems and it shows how fabrication issues can be addressed at the design level and vice versa. The

  7. Selected emerging diseases of amphibia.

    Science.gov (United States)

    Latney, La'Toya V; Klaphake, Eric

    2013-05-01

    This review summarizes the most recent updates on emerging infectious diseases of amphibia. A brief summary of Batrachochytrium dendrobatidis history, epidemiology, pathogenesis, life cycle, diagnosis, treatment, and biosecurity is provided. Ambystoma tigrinum virus, common midwife toad virus, frog virus 3, Rana grylio virus, Rana catesbeiana ranavirus, Mahaffey Road virus, Rana esculenta virus, Bohle iridovirus, and tiger frog virus ranaviruses are extensively reviewed. Emerging bacterial pathogens are discussed, including Flavobacter sp, Aeromonas sp, Citrobacter freundii, Chlamydophila sp, Mycobacterium liflandii, Elizabethkingia meningoseptica, and Ochrobactrum anthropi. Rhabdias sp, Ribeiroia sp, and Spirometra erinacei are among several of the parasitic infections overviewed in this article. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. 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.

  9. Emergency Management: The Human Factor

    Science.gov (United States)

    1986-07-01

    Harriet L. Tamminga, Thomas S. Kilijanek and Christopher Adams. Managing Multiorganizational Emergency Responses: D~ergent Search and Rescue Networks in...Minneapolis, Minnesota: Family Study Center, University of Minnesota, 1982. Lindy, Jacob D., Mary C. Grace, and Bonnie L. Green. "Survivors: Outreach

  10. Connected health: emerging disruptive technologies

    National Research Council Canada - National Science Library

    Iglehart, John K

    2014-01-01

    ... the confusion over the definitions of telemedicine, telehealth, and mHealth. The importance of an array of emerging technologies and services is certain to grow as more people who reside in rural locales or areas of provider scarcity gain coverage and team-based care becomes a more prominent feature of the delivery landscape. In addition, as former Senate M...

  11. In Case of Pesticide Emergency

    Science.gov (United States)

    ... and Consumers Contact Us Share In Case of Pesticide Emergency If someone has swallowed or inhaled a pesticide or gotten it in the eye or on ... for help with first aid information. The National Pesticide Information Center (NPIC) (1-800-858-7378) also ...

  12. 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.

  13. Improving Emergency Attendance and Mortality

    African Journals Online (AJOL)

    daddy

    then triage and provide first line care to all such emergencies. The patients were subsequently reviewed by the specialist team as appropriate. Nurses and allied staff supported the duty doctors all of whom worked on a shift basis. Ethical Consideration: After a quality assurance assessment, a proposal was made to run this ...

  14. 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…

  15. 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.

  16. Electronic Emergency-Department Whiteboards

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2011-01-01

    Purpose. Many emergency departments (EDs) are in a process of transitioning from dry-erase to electronic whiteboards. This study investigates differences in ED clinicians’ perception and assessment of their electronic whiteboards across departments and staff groups and at two points in time. Method...

  17. More about ... Paediatric emergency medicine

    African Journals Online (AJOL)

    More about ... Paediatric emergency medicine. What's new in toxicology? K H Balme, MB ChB ... and European Academies of Clinical. Toxicologists published new guidelines.4. These emphasise that patients .... in Australia and New Zealand – explanation and elaboration. A consensus statement from clinical toxicologists ...

  18. Shock in the emergency department

    DEFF Research Database (Denmark)

    Holler, Jon Gitz; Henriksen, Daniel Pilsgaard; Mikkelsen, Søren

    2016-01-01

    BACKGROUND: The knowledge of the frequency and associated mortality of shock in the emergency department (ED) is limited. The aim of this study was to describe the incidence, all-cause mortality and factors associated with death among patients suffering shock in the ED. METHODS: Population...

  19. Emergency Preparedness: Are You Ready?

    Science.gov (United States)

    Harley, Lorraine

    2012-01-01

    Most Americans who consider emergency preparedness think of someone or another country attacking the United States. Most newspaper and televised accounts involve community leaders and policymakers preparing for a terrorist attack. However, anyone who operates a child care center, family child care home, or has children of her own, knows that…

  20. What's In Your Emergency Kit?

    Centers for Disease Control (CDC) Podcasts

    2012-12-04

    An emergency kit can help you survive during a disaster. This podcast discusses supplies to include in your kit.  Created: 12/4/2012 by Office of Public Health Preparedness and Response (OPHPR).   Date Released: 12/20/2012.

  1. 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

  2. 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)

  3. Emergence Issues - not so simple

    African Journals Online (AJOL)

    emergence are hypertension, hypotension and arrhythmias. These complications may be related to cardiovascular comorbidities e.g. coronary artery disease, hypertension and blood loss. • Hypotension from hypovolaemia, myocardial failure, sepsis, spinals and epidurals need to be corrected before discharge to the ward.

  4. Emergency Surgery for Metastatic Melanoma

    Directory of Open Access Journals (Sweden)

    Dimitrios Mantas

    2014-01-01

    Full Text Available Visceral metastases from malignant melanoma (stage M1c confer a very poor prognosis, as documented on the most recent revised version of the TNM/AJCC staging system. Emergency surgery for intra-abdominal complications from the disease is rare. We report on our 5-year single institution experience with surgical management of metastatic melanoma to the viscera in the emergent setting. From 2009 to 2013, 14 patients with metastatic melanoma were admitted emergently due to an acute abdomen. Clinical manifestations encompassed intestinal obstruction and bleeding. Surgical procedures involved multiple enterectomies with primary anastomoses in 8 patients, and one patient underwent splenectomy, one adrenalectomy, one right colectomy, one gastric wedge resection, one gastrojejunal anastomosis, and one transanal debulking, respectively. The 30-day mortality was 7 percent. Median follow-up was 14 months. Median overall survival was 14 months. Median disease free survival was 7.5 months. One-year overall survival was 64.2 percent and 2-year overall survival was 14.2 percent. Emergency surgery for metastatic melanoma to the viscera is rare. Elective curative surgery combined with novel cytotoxic systemic therapies is under investigation in an attempt to grant survival benefit in melanoma patients with visceral disease.

  5. 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...

  6. 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.

  7. Principles of Emergency Preparedness Planning.

    Science.gov (United States)

    Hindman, R. Eugene, Jr.

    1985-01-01

    Steps and considerations in developing an institutional plan for emergency preparedness are discussed, including delineation of internal and external responsibilities, warning systems, a means for activating the plan, a command headquarters, medical facilities, housing and food, internal and external communications, transportation, and testing and…

  8. Emerging trends in surface metrology

    DEFF Research Database (Denmark)

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

    2002-01-01

    Recent advancements and some emerging trends in the methods and instruments used for surface and near surface characterisation are presented, considering the measurement of both topography and physical properties. In particular, surfaces that present difficulties in measurement or require new pro...

  9. 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.

  10. Emergence Issues - not so simple

    African Journals Online (AJOL)

    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 general anaesthetic that includes a return to spontaneous breathing, voluntary swallowing and normal consciousness.1 It is ...

  11. Data modelling for emergency response

    NARCIS (Netherlands)

    Dilo, Arta; Zlatanova, Sidi

    2010-01-01

    Emergency response is one of the most demanding phases in disaster management.The fire brigade, paramedics, police and municipality are the organisations involved in the first response to the incident. They coordinate their work based on welldefined policies and procedures, but they also need the

  12. Emerging Technologies in Physics Education

    Science.gov (United States)

    Krusberg, Zosia A. C.

    2007-01-01

    Three emerging technologies in physics education are evaluated from the interdisciplinary perspective of cognitive science and physics education research. The technologies--Physlet Physics, the Andes Intelligent Tutoring System (ITS), and Microcomputer-Based Laboratory (MBL) Tools--are assessed particularly in terms of their potential at promoting…

  13. Treating epileptic emergencies - pharmacological advances.

    Science.gov (United States)

    Zelano, Johan; Ben-Menachem, Elinor

    2016-10-14

    Epileptic emergencies are frequently encountered and include ictal events as status epilepticus or seizure clusters, and non-ictal situations like postictal psychosis or acute drug side effects. The aim of this review was to describe recent pharmacological advances in the treatment of epileptic emergencies. Areas covered: Based on clinically relevant questions, a literature search was performed. The search showed that most pharmacological advances have been made in management of status epilepticus, where substantial literature has accumulated on several AEDs with potentially less side-effects than the traditional choices. The use of these drugs; valproate, levetiracetam, and lacosamide, was therefore made the main focus of this review. Pharmacological advances in treatment of other epileptic emergencies were scarce, and were therefore covered more briefly in the Expert Opinion section. Expert opinion: This section outlines our current practice in management of status epilepticus and seizures clusters. Our opinion is that valproate is an equal alternative as second line treatment to fosphenytoin, with levetiracetam considered a good choice in frail and elderly patients. Due to the lack of literature, lacosamide is used mainly as a 2nd line drug after the failure of valproate, fosphenytoin and levetiracetam. Our review underlines the need for more research in management of epileptic emergencies.

  14. Suspension as an Emergency Power

    National Research Council Canada - National Science Library

    Amanda L. Tyler

    2009-01-01

    ... Legislation B. Suspension During Reconstruction: Putting Down the Klan in South Carolina IV. UNDERSTANDING SUSPENSION AS AN EMERGENCY POWER A. Reading the Suspension Clause in Context B. Giving Meaning to the Suspension Power C. Mapping the Suspension Clause Within the Constitution V. SUSPENSION AND THE SEPARATION OF POWERS CONCLUSION [A] suspensio...

  15. 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…

  16. Anesthetic protocols for common emergencies.

    Science.gov (United States)

    Campbell, Vicki L

    2005-03-01

    Anesthesia, sedation, and pain management should be taken seriously in the emergency patient. Proper knowledge of the drugs available and their pharmacokinetics and pharmacodynamics are necessary to administer anesthesia safely to critical patients. A proactive approach regarding monitoring, titration of anesthetic drugs, and anticipation of life-threatening complications helps in achieving successful anesthetic outcomes.

  17. Professional Emergence on Transnational Issues

    DEFF Research Database (Denmark)

    Seabrooke, Leonard; Tsingou, Eleni

    2015-01-01

    and what are included and excluded. A linked ecologies approach provides a fruitful way of identifying actors and distinctions on issues that are emergent. These conceptual and methodological points are demonstrated through a study of how medical experts, demographers, and economists forge issue...

  18. 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

  19. Emergency Navigation without an Infrastructure

    Directory of Open Access Journals (Sweden)

    Erol Gelenbe

    2014-08-01

    Full Text Available 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.

  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.

  1. Occupational health and safety emergencies.

    Science.gov (United States)

    Goupil, M T

    1995-07-01

    When considering potentials emergencies in the dental office, one usually first thinks about potential drug reactions or adverse response to underlying systemic diseases. The rare, but potential, emergencies arising from the office environment itself also exist. Toxic reactions to various chemicals found in the office must be considered also. Adequate ventilation helps prevent the long-term consequences of breathing nitrous oxide and chemclave exhaust. Care must be taken in obtaining complete medical histories. Identify patients with communicable diseases such as TB. The potential for transmission of these infections to office staff and other patients exists. Health histories must include the ability to identify patients with latex sensitivity. The increased use of latex products among health care workers has resulted in a higher incidence of latex sensitivity. The office staff must be prepared to recognize and quickly treat anaphylactic reactions. A latex-free environment must be provided for high-risk patients. Even with the use of universal precautions, blood contamination exposures and needle sticks will still occur. Protect office staff against hepatitis through the administration of a hepatitis prevention vaccine. Establish a protocol in advance for handling blood exposure incidents. Update the patient history to determine potential risk. The exposed individual must receive counseling as to the potential risk of HIV infection. If there is a potential risk of HIV contamination, the exposed individual must be offered the opportunity to initiate prophylactic chemotherapy within 1 hour of exposure. Even though occupational health and safety emergencies are rare, they must be considered and planned for. Contingency plans, such as providing a latex-free environment, must be available for preventing emergencies. The office staff must be prepared to treat immediate emergencies such as anaphylaxis and caustic material spills. Arrangements must be available to quickly

  2. [On hospital emergency department crowding].

    Science.gov (United States)

    Tudela, Pere; Mòdol, Josep Maria

    2015-01-01

    Recent years have seen a range of measures deployed to curb crowding in hospital emergency departments, but as episodes of overcrowding continue to occur the discussion of causes and possible solutions remains open. The problem is universal, and efforts to revamp health care systems as a result of current socioeconomic circumstances have put emergency services in the spotlight. Consensus was recently achieved on criteria that define emergency department overcrowding. The causes are diverse and include both external factors and internal ones, in the form of attributes specific to a department. The factors that have the most impact, however, involve hospital organization, mainly the availability of beds and the difficulty of assigning them to emergency patients requiring admission. Crowding is associated with decreases in most health care quality indicators, as departments see increases in the number of patients waiting, the time until initial processing, and the time until a physician or nurse intervenes. Crowding is also associated with risk for more unsatisfactory clinical outcomes. This situation leads to dissatisfaction all around-of patients, families, and staff-as aspects such as dignity, comfort, and privacy deteriorate. Proposals to remedy the problem include assuring that the staff and structural resources of a facility meet minimum standards and are all working properly, facilitating access to complementary tests, and providing observation areas and short-stay units. The response of hospitals to the situation in emergency departments should include alternatives to conventional admission, through means for rapid diagnosis, day hospitals, and home hospitalization as well as by offering a clear response in cases where admission is needed, granting easier access to beds that are in fact available. For its part, the health system overall, should improve the care of patients with chronic diseases, so that fewer admissions are required. It is also essential to

  3. 14 CFR 23.812 - Emergency lighting.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Emergency lighting. 23.812 Section 23.812... Cargo Accommodations § 23.812 Emergency lighting. When certification to the emergency exit provisions of § 23.807(d)(4) is requested, the following apply: (a) An emergency lighting system, independent of the...

  4. 46 CFR 131.840 - Emergency lighting.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Emergency lighting. 131.840 Section 131.840 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS OPERATIONS Markings for Fire Equipment and Emergency Equipment § 131.840 Emergency lighting. Emergency lighting must be marked...

  5. 36 CFR 28.14 - Emergency action.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Emergency action. 28.14... Emergency action. If allowable by local law and if immediate action is essential to avoid or eliminate an... for undertaking the emergency action no longer exist, the agency or person shall cease an emergency...

  6. 77 FR 38248 - Passenger Train Emergency Preparedness

    Science.gov (United States)

    2012-06-27

    ... Emergency Systems (PTES I) Final Rule C. 2012 Passenger Train Emergency Systems (PTES II) NPRM D. The Need.... ] B. 2008 Passenger Train Emergency Systems (PTES I) Final Rule In 2008, FRA revisited requirements... Train Emergency Systems (PTES II) NPRM On January 3, 2012, FRA published an NPRM proposing to enhance...

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

    Science.gov (United States)

    Lee, Jessica K; Schwarz, Eleanor Bimla

    2017-10-01

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

  8. Emerging non-volatile memories

    CERN Document Server

    Hong, Seungbum; Wouters, Dirk

    2014-01-01

    This book is an introduction to the fundamentals of emerging non-volatile memories and provides an overview of future trends in the field. Readers will find coverage of seven important memory technologies, including Ferroelectric Random Access Memory (FeRAM), Ferromagnetic RAM (FMRAM), Multiferroic RAM (MFRAM), Phase-Change Memories (PCM), Oxide-based Resistive RAM (RRAM), Probe Storage, and Polymer Memories. Chapters are structured to reflect diffusions and clashes between different topics. Emerging Non-Volatile Memories is an ideal book for graduate students, faculty, and professionals working in the area of non-volatile memory. This book also: Covers key memory technologies, including Ferroelectric Random Access Memory (FeRAM), Ferromagnetic RAM (FMRAM), and Multiferroic RAM (MFRAM), among others. Provides an overview of non-volatile memory fundamentals. Broadens readers' understanding of future trends in non-volatile memories.

  9. ICT Innovation in Emerging Economies

    DEFF Research Database (Denmark)

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

    2013-01-01

    a third of the world’s largest 25 economies, and that they are likely to be critical for the success of a global economy, it is important to understand how these economies innovate, what factors affect innovation in such nations, and what are the impacts. However, to the best of our knowledge, little...... 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.......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...

  10. Emergent functions of quantum materials

    Science.gov (United States)

    Tokura, Yoshinori; Kawasaki, Masashi; Nagaosa, Naoto

    2017-11-01

    Materials can harbour quantum many-body systems, most typically in the form of strongly correlated electrons in solids, that lead to novel and remarkable functions thanks to emergence--collective behaviours that arise from strong interactions among the elements. These include the Mott transition, high-temperature superconductivity, topological superconductivity, colossal magnetoresistance, giant magnetoelectric effect, and topological insulators. These phenomena will probably be crucial for developing the next-generation quantum technologies that will meet the urgent technological demands for achieving a sustainable and safe society. Dissipationless electronics using topological currents and quantum spins, energy harvesting such as photovoltaics and thermoelectrics, and secure quantum computing and communication are the three major fields of applications working towards this goal. Here, we review the basic principles and the current status of the emergent phenomena and functions in materials from the viewpoint of strong correlation and topology.

  11. Emerging nanotechnologies for cancer immunotherapy.

    Science.gov (United States)

    Shukla, Sourabh; Steinmetz, Nicole F

    2016-05-01

    Founded on the growing insight into the complex cancer-immune system interactions, adjuvant immunotherapies are rapidly emerging and being adapted for the treatment of various human malignancies. Immune checkpoint inhibitors, for example, have already shown clinical success. Nevertheless, many approaches are not optimized, require frequent administration, are associated with systemic toxicities and only show modest efficacy as monotherapies. Nanotechnology can potentially enhance the efficacy of such immunotherapies by improving the delivery, retention and release of immunostimulatory agents and biologicals in targeted cell populations and tissues. This review presents the current status and emerging trends in such nanotechnology-based cancer immunotherapies including the role of nanoparticles as carriers of immunomodulators, nanoparticles-based cancer vaccines, and depots for sustained immunostimulation. Also highlighted are key translational challenges and opportunities in this rapidly growing field. © 2016 by the Society for Experimental Biology and Medicine.

  12. The Emergence of City Logistics

    DEFF Research Database (Denmark)

    Gammelgaard, Britta

    2015-01-01

    Purpose: – Many city logistics projects in Europe have failed. A better understanding of the complex organizational change processes in city logistics projects with many stakeholders may expand city logistics capabilities and thereby help prevent future failures. The purpose of this paper...... is therefore to increase understanding of how city logistics emerge, and secondarily, to investigate whether such processes can be managed at all. Design/methodology/approach: – A paradigm shift in urban planning creates new ways of involving stakeholders in new sustainability measures such as city logistics....... Organizational change theory is applied to capture the social processes leading to emergence of city logistics. The methodology is a qualitative processual analysis of a single longitudinal case. Findings: – The change process took different forms over time. At the time of concluding the analysis, positive...

  13. The emergence of urban centres

    DEFF Research Database (Denmark)

    Lazaro, Evelyn; Agergaard, Jytte; Larsen, Marianne Nylandsted

    In this paper we aim at understanding how social and spatial transformation of dynamic rural regions is driving spatial concentration and urbanization. We are particularly concerned with the processes of spatial change, verbalized as the emergence of urban centres in rural areas. Emerging Urban...... Centres (EUCs) are characterized by rapid population growth related to continuous and diverse flows of migrants from rural hinterlands and more detached rural locations. Many of these centres are also characterized by economic dynamics related to agricultural sector activities that have been stimulated...... by Tanzanian market liberalizations and its long term effects on private enterprise. The paper is based on a study of four EUCs in Tanzania (Ilula, Igowole, Madizini and Kibaigwa) and seeks to answer three research questions: 1) What economic and spatial trends, including national policies, have formed...

  14. Moral distress in emergency nurses.

    Science.gov (United States)

    Fernandez-Parsons, Robin; Rodriguez, Lori; Goyal, Deepika

    2013-11-01

    For nurses, moral distress leads to burnout, attrition, compassion fatigue, and patient avoidance. Using a quantitative, cross-sectional, and descriptive design, we assessed the frequency, intensity, and type of moral distress in 51 emergency nurses in 1 community hospital using a 21-item, self-report, Likert-type questionnaire. Results showed a total mean moral distress level of 3.18, indicative of overall low moral distress. Situations with the highest levels of moral distress were related to the competency of health care providers and following family wishes to continue life support, also known as futile care. Moral distress was the reason given by 6.6% of registered nurses for leaving a previous position, 20% said that they had considered leaving a position but did not, and 13.3% stated that they are currently considering leaving their position because of moral distress. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  15. Emergence of Leadership in Communication.

    Science.gov (United States)

    Allahverdyan, Armen E; Galstyan, Aram

    2016-01-01

    We study a neuro-inspired model that mimics a discussion (or information dissemination) process in a network of agents. During their interaction, agents redistribute activity and network weights, resulting in emergence of leader(s). The model is able to reproduce the basic scenarios of leadership known in nature and society: laissez-faire (irregular activity, weak leadership, sizable inter-follower interaction, autonomous sub-leaders); participative or democratic (strong leadership, but with feedback from followers); and autocratic (no feedback, one-way influence). Several pertinent aspects of these scenarios are found as well-e.g., hidden leadership (a hidden clique of agents driving the official autocratic leader), and successive leadership (two leaders influence followers by turns). We study how these scenarios emerge from inter-agent dynamics and how they depend on behavior rules of agents-in particular, on their inertia against state changes.

  16. Moonlighting peptides with emerging function.

    Directory of Open Access Journals (Sweden)

    Jonathan G Rodríguez Plaza

    Full Text Available Hunter-killer peptides combine two activities in a single polypeptide that work in an independent fashion like many other multi-functional, multi-domain proteins. We hypothesize that emergent functions may result from the combination of two or more activities in a single protein domain and that could be a mechanism selected in nature to form moonlighting proteins. We designed moonlighting peptides using the two mechanisms proposed to be involved in the evolution of such molecules (i.e., to mutate non-functional residues and the use of natively unfolded peptides. We observed that our moonlighting peptides exhibited two activities that together rendered a new function that induces cell death in yeast. Thus, we propose that moonlighting in proteins promotes emergent properties providing a further level of complexity in living organisms so far unappreciated.

  17. Emerging issues in complementary feeding

    DEFF Research Database (Denmark)

    Michaelsen, Kim F.; Grummer-Strawn, Laurence; Bégin, France

    2017-01-01

    The complementary feeding period (6-24 months) is a window of opportunity for preventing stunting, wasting, overweight, and obesity and for improving long-term development and health. Because WHO published its guiding principles for complementary feeding in 2003, new knowledge and evidence have...... addressed these issues. There are several emerging research areas that are likely to provide a better understanding of how complementary feeding influences growth, development, and health. These include the effect of the young child's diet on body composition, gastrointestinal microbiota, and environmental...... enteric dysfunction. However, at present, findings from these research areas are not likely to influence guidelines. Several emerging issues will be relevant to address when complementary feeding guidelines will be updated. With the increasing prevalence of obesity globally, it is important...

  18. Antibacterial resistance: an emerging 'zoonosis'?

    Science.gov (United States)

    Labro, Marie-Thérèse; Bryskier, Jean-Marie

    2014-12-01

    Antibacterial resistance is a worldwide threat, and concerns have arisen about the involvement of animal commensal and pathogenic bacteria in the maintenance and spread of resistance genes. However, beyond the facts related to the occurrence of resistant microorganisms in food, food-producing animals and companion animals and their transmission to humans, it is important to consider the vast environmental 'resistome', the selective pathways underlying the emergence of antibacterial resistance and how we can prepare answers for tomorrow.

  19. In-flight Medical Emergencies

    OpenAIRE

    Amit Chandra; Shauna Conry

    2013-01-01

    Introduction: Research and data regarding in-flight medical emergencies during commercial air travel are lacking. Although volunteer medical professionals are often called upon to assist, there are no guidelines or best practices to guide their actions. This paper reviews the literature quantifying and categorizing in-flight medical incidents, discusses the unique challenges posed by the in-flight environment, evaluates the legal aspects of volunteering to provide care, and suggests an approa...

  20. Lateral reference transformation for emergence

    OpenAIRE

    Ratnaike, Arvind Viranga

    2017-01-01

    This thesis investigates transformation of forms of indication; a transition from data in one form to a description in another form. The data input indicates a situation; the description output indicates a situation. Though both should, ideally, indicate the same situation, there is likely to be a drift in what situation is indicated. A theory for transformation by emergence is introduced, as is a framework for the transformation. The framework can transform an available known ...

  1. HDL, Atherosclerosis, and Emerging Therapies

    OpenAIRE

    Anouar Hafiane; Jacques Genest

    2013-01-01

    This review aims to provide an overview on the properties of high-density lipoproteins (HDLs) and their cardioprotective effects. Emergent HDL therapies will be presented in the context of the current understanding of HDL function, metabolism, and protective antiatherosclerotic properties. The epidemiological association between levels of HDL-C or its major apolipoprotein (apoA-I) is strong, graded, and coherent across populations. HDL particles mediate cellular cholesterol efflux, have antio...

  2. An Emergence Framework of Carcinogenesis.

    Science.gov (United States)

    Sigston, Elizabeth A W; Williams, Bryan R G

    2017-01-01

    Experimental paradigms provide the framework for the understanding of cancer, and drive research and treatment, but are rarely considered by clinicians. The somatic mutation theory (SMT), in which cancer is considered a genetic disease, has been the predominant traditional model of cancer for over 50 years. More recently, alternative theories have been proposed, such as tissue organization field theory (TOFT), evolutionary models, and inflammatory models. Key concepts within the various models have led to them being difficult to reconcile. Progressively, it has been recognized that biological systems cannot be fully explained by the physicochemical properties of their constituent parts. There is an increasing call for a 'systems' approach. Incorporating the concepts of 'emergence', 'systems', 'thermodynamics', and 'chaos', a single integrated framework for carcinogenesis has been developed, enabling existing theories to become compatible as alternative mechanisms, facilitating the integration of bioinformatics and providing a structure in which translational research can flow from both 'benchtop to bedside' and 'bedside to benchtop'. In this review, a basic understanding of the key concepts of 'emergence', 'systems', 'system levels', 'complexity', 'thermodynamics', 'entropy', 'chaos', and 'fractals' is provided. Non-linear mathematical equations are included where possible to demonstrate compatibility with bioinformatics. Twelve principles that define the 'emergence framework of carcinogenesis' are developed, with principles 1-10 encapsulating the key concepts upon which the framework is built and their application to carcinogenesis. Principle 11 relates the framework to cancer progression. Principle 12 relates to the application of the framework to translational research. The 'emergence framework of carcinogenesis' collates current paradigms, concepts, and evidence around carcinogenesis into a single framework that incorporates previously incompatible viewpoints

  3. Emergency management of hyperemesis gravidarum.

    Science.gov (United States)

    Summers, Anthony

    2012-07-01

    Most pregnant women experience morning sickness during the first 20 weeks of pregnancy. Often, the symptoms are mild, but recurring, nausea and vomiting; but the condition can also lead to dehydration, weight loss, electrolyte imbalance and blood volume depletion, and many women with more severe forms of the condition present to emergency departments. This article describes the presenting symptoms, causes of hyperemesis gravidarum, the associated clinical signs and complications, and the most common treatments offered.

  4. Emergent Resource Sharing & Interlibrary Loan

    OpenAIRE

    Oberlander, Cyril

    2006-01-01

    Resource sharing and Interlibrary Loan face exciting opportunities to develop new connections between information and library resources and services. Emergent consumer technology is radically changing the nature of Library service; however, we can shape the transformation of resource sharing and interlibrary loan. Framing the evolution of request management systems and resource sharing workflow are communities of adaptations to the changed information and technology landscape. The redefini...

  5. Emergency medicine of the ferret.

    Science.gov (United States)

    Pollock, Christal

    2007-05-01

    Common emergency conditions seen in the ferret include insulinoma, cardiomyopathy, and urethral obstruction. When developing a diagnostic and therapeutic plan, the ferret veterinarian must seek a balance between species-specific information and information extrapolated from cat and dog medicine. The therapeutic plan must always include close and careful monitoring. Significant changes in the status of these small patients can occur extremely quickly in the course of providing basic supportive care, such as intravenous fluids or supplemental heat.

  6. Psoriasis: classical and emerging comorbidities*

    Science.gov (United States)

    de Oliveira, Maria de Fátima Santos Paim; Rocha, Bruno de Oliveira; Duarte, Gleison Vieira

    2015-01-01

    Psoriasis is a chronic inflammatory systemic disease. Evidence shows an association of psoriasis with arthritis, depression, inflammatory bowel disease and cardiovascular diseases. Recently, several other comorbid conditions have been proposed as related to the chronic inflammatory status of psoriasis. The understanding of these conditions and their treatments will certainly lead to better management of the disease. The present article aims to synthesize the knowledge in the literature about the classical and emerging comorbidities related to psoriasis. PMID:25672294

  7. Emerging technologies in physics education

    OpenAIRE

    Krusberg, Zosia A. C.

    2007-01-01

    Three emerging technologies in physics education are evaluated from the interdisciplinary perspective of cognitive science and physics education research. The technologies - Physlet Physics, the Andes Intelligent Tutoring System (ITS), and Microcomputer-Based Laboratory (MBL) Tools - are assessed particularly in terms of their potential at promoting conceptual change, developing expert-like problem-solving skills, and achieving the goals of the traditional physics laboratory. Pedagogical meth...

  8. Approach to Reptile Emergency Medicine.

    Science.gov (United States)

    Long, Simon Y

    2016-05-01

    This article summarizes the physiology and anatomy of reptiles, highlighting points relevant for emergency room veterinarians. Other systems, such as the endocrine and immune systems, have not been covered. The many other aspects of reptile species variation are too numerous to be covered. This article provides an overview but encourages clinicians to seek additional species-specific information to better medically diagnose and treat their reptile patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Emerging Prospects for Repository Success

    Energy Technology Data Exchange (ETDEWEB)

    Isaacs, T

    2006-01-12

    Recent events are again raising some old issues and creating new opportunities regarding the future disposition of the used, or spent, fuel from nuclear power plants. Handling these challenges well will not only help set the stage for a robust nuclear energy future, but will reflect the growing linkages among nuclear power, nuclear waste management, international security, and public and political acceptance. The emerging global nuclear regime may make spent fuel management not only more important, but improve chances of success.

  10. Accident knowledge and emergency management

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, B.; Groenberg, C.D.

    1997-03-01

    The report contains an overall frame for transformation of knowledge and experience from risk analysis to emergency education. An accident model has been developed to describe the emergency situation. A key concept of this model is uncontrolled flow of energy (UFOE), essential elements are the state, location and movement of the energy (and mass). A UFOE can be considered as the driving force of an accident, e.g., an explosion, a fire, a release of heavy gases. As long as the energy is confined, i.e. the location and movement of the energy are under control, the situation is safe, but loss of confinement will create a hazardous situation that may develop into an accident. A domain model has been developed for representing accident and emergency scenarios occurring in society. The domain model uses three main categories: status, context and objectives. A domain is a group of activities with allied goals and elements and ten specific domains have been investigated: process plant, storage, nuclear power plant, energy distribution, marine transport of goods, marine transport of people, aviation, transport by road, transport by rail and natural disasters. Totally 25 accident cases were consulted and information was extracted for filling into the schematic representations with two to four cases pr. specific domain. (au) 41 tabs., 8 ills.; 79 refs.

  11. Emergence of Supersymmetric Quantum Electrodynamics.

    Science.gov (United States)

    Jian, Shao-Kai; Lin, Chien-Hung; Maciejko, Joseph; Yao, Hong

    2017-04-21

    Supersymmetric (SUSY) gauge theories such as the minimal supersymmetric standard model play a fundamental role in modern particle physics, but have not been verified so far in nature. Here, we show that a SUSY gauge theory with dynamical gauge bosons and fermionic gauginos emerges naturally at the pair-density-wave (PDW) quantum phase transition on the surface of a correlated topological insulator hosting three Dirac cones, such as the topological Kondo insulator SmB_{6}. At the quantum tricritical point between the surface Dirac semimetal and nematic PDW phases, three massless bosonic Cooper pair fields emerge as the superpartners of three massless surface Dirac fermions. The resulting low-energy effective theory is the supersymmetric XYZ model, which is dual by mirror symmetry to N=2 supersymmetric quantum electrodynamics in 2+1 dimensions, providing a first example of emergent supersymmetric gauge theory in condensed matter systems. Supersymmetry allows us to determine certain critical exponents and the optical conductivity of the surface states at the strongly coupled tricritical point exactly, which may be measured in future experiments.

  12. Emerging and reemerging of filoviruses.

    Science.gov (United States)

    Feldmann, H; Slenczka, W; Klenk, H D

    1996-01-01

    Filoviruses are causative agents of a hemorrhagic fever in man with mortalities ranging from 22 to 88%. They are enveloped, nonsegmented negative-stranded RNA viruses and are separated into two types, Marburg and Ebola, which can be serologically, biochemically and genetically distinguished. In general, there is little genetic variability among viruses belonging to the Marburg type. The Ebola type, however, is subdivided into at least three distinct subtypes. Marburg virus was first isolated during an outbreak in Europe in 1967. Ebola virus emerged in 1976 as the causative agent of two simultaneous outbreaks in southern Sudan and northern Zaire. The reemergence of Ebola, subtype Zaire, in Kikwit 1995 caused a worldwide sensation, since it struck after a sensibilization on the danger of Ebola virus disease. Person-to-person transmission by intimate contact is the main route of infection, but transmission by droplets and small aerosols among infected individuals is discussed. The natural reservoir for filoviruses remains a mystery. Filoviruses are prime examples for emerging pathogens. Factors that may be involved in emergence are international commerce and travel, limited experience in diagnosis and case management, import of nonhuman primates, and the potential of filoviruses for rapid evolution.

  13. Emerging exposures of developmental toxicants.

    Science.gov (United States)

    Wolff, Mary S; Buckley, Jessie P; Engel, Stephanie M; McConnell, Rob S; Barr, Dana B

    2017-04-01

    The purpose of this review is to identify emerging developmental toxicants that are understudied in children's health. Exposures may arise from new products designed to improve utility, to reduce toxicity, or to replace undesirable chemicals. Exposures to less-toxic chemicals may also be significant if they are very commonly used, thereby generating widespread exposure. Sources of exposure include the workplace, personal, home, and office products; food, water, and air. We describe eight exposure categories that contain numerous potential developmental toxicants. References are discussed if reported in PubMed during the past decade at least 10 times more frequently than in 1990-2000. Examples included phthalates, phenols, sunscreens, pesticides, halogenated flame retardants, perfluoroalkyl coatings, nanoparticles, e-cigarettes, and dietary polyphenols. Replacements are often close structural homologs of their precursors. We suggest biomonitoring as preferred means of exposure assessment to emerging chemicals. Some existing analytic methods would require minimal modification to measure these exposures, but others require toxicokinetic and analytic investigation. A deliberate strategy for biomonitoring of emerging replacement chemicals is warranted, especially in view of concerns regarding developmental toxicity. To prevent adverse health effects, it is important to characterize such exposures before they become widely disseminated.

  14. Emergence: Complexity Pedagogy in Action

    Science.gov (United States)

    Jonas-Simpson, Christine

    2015-01-01

    Many educators are looking for new ways to engage students and each other in order to enrich curriculum and the teaching-learning process. We describe an example of how we enacted teaching-learning approaches through the insights of complexity thinking, an approach that supports the emergence of new possibilities for teaching-learning in the classroom and online. Our story begins with an occasion to meet with 10 nursing colleagues in a three-hour workshop using four activities that engaged learning about complexity thinking and pedagogy. Guiding concepts for the collaborative workshop were nonlinearity, distributed decision-making, divergent thinking, self-organization, emergence, and creative exploration. The workshop approach considered critical questions to spark our collective inquiry. We asked, “What is emergent learning?” and “How do we, as educators and learners, engage a community so that new learning surfaces?” We integrated the arts, creative play, and perturbations within a complexity approach. PMID:25838945

  15. Emergence: Complexity Pedagogy in Action

    Directory of Open Access Journals (Sweden)

    Christine Jonas-Simpson

    2015-01-01

    Full Text Available Many educators are looking for new ways to engage students and each other in order to enrich curriculum and the teaching-learning process. We describe an example of how we enacted teaching-learning approaches through the insights of complexity thinking, an approach that supports the emergence of new possibilities for teaching-learning in the classroom and online. Our story begins with an occasion to meet with 10 nursing colleagues in a three-hour workshop using four activities that engaged learning about complexity thinking and pedagogy. Guiding concepts for the collaborative workshop were nonlinearity, distributed decision-making, divergent thinking, self-organization, emergence, and creative exploration. The workshop approach considered critical questions to spark our collective inquiry. We asked, “What is emergent learning?” and “How do we, as educators and learners, engage a community so that new learning surfaces?” We integrated the arts, creative play, and perturbations within a complexity approach.

  16. Simulation analysis of the use of emergency resources during the emergency response to a major fire

    NARCIS (Netherlands)

    Zhou, Jianfeng; Reniers, G.L.L.M.E.

    2016-01-01

    During an emergency response to an accident or disaster, emergency response actions often need to use various emergency resources. The use of resources plays an important role in the successful implementation of emergency response, but there may be conflicts in the use of resources for emergency

  17. Review article: burnout in emergency medicine physicians.

    Science.gov (United States)

    Arora, Manit; Asha, Stephen; Chinnappa, Jason; Diwan, Ashish D

    2013-12-01

    Training and the practice of emergency medicine are stressful endeavours, placing emergency medicine physicians at risk of burnout. Burnout syndrome is associated with negative outcomes for patients, institutions and the physician. The aim of this review is to summarise the available literature on burnout among emergency medicine physicians and provide recommendations for future work in this field. A search of MEDLINE (1946-present) (search terms: 'Burnout, Professional' AND 'Emergency Medicine' AND 'Physicians'; 'Stress, Psychological' AND 'Emergency Medicine' AND 'Physicians') and EMBASE (1988-present) (search terms: 'Burnout' AND 'Emergency Medicine' AND 'Physicians'; 'Mental Stress' AND 'Emergency Medicine' AND 'Physicians') was performed. The authors focused on articles that assessed burnout among emergency medicine physicians. Most studies used the Maslach Burnout Inventory to quantify burnout, allowing for cross-study (and cross-country) comparisons. Emergency medicine has burnout levels in excess of 60% compared with physicians in general (38%). Despite this, most emergency medicine physicians (>60%) are satisfied with their jobs. Both work-related (hours of work, years of practice, professional development activities, non-clinical duties etc.) and non-work-related factors (age, sex, lifestyle factors etc.) are associated with burnout. Despite the heavy burnout rates among emergency medicine physicians, little work has been performed in this field. Factors responsible for burnout among various emergency medicine populations should be determined, and appropriate interventions designed to reduce burnout. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  18. Emergency cricothyrotomy in confined space airway emergencies: a comparison.

    Science.gov (United States)

    Givens, Gregory C; Shelton, Stephen L; Brown, Eric A

    2011-08-01

    In confined-space airway emergencies, prehospital personnel may need to perform cricothyrotomy when conventional airway techniques cannot be utilized or have failed. This study is a prospective, cross-over, randomized controlled trial that compares two widely-known techniques using two commercially available kits. Twenty residents at Palmetto Health Richland Department of Emergency Medicine participated in the study. Their performance was assessed using the time required to placement and correctness of placement for each device. The residents performed the procedures on an Air-Man™ manikin that had been situated in a confined space.The residents also indicated which kit they would prefer in a confined-space, emergency airway situation. All of the devices were placed in the airway. The mean time to placement for the Melker™ and Quicktrach™ kits was 108.5 seconds and 23.9 seconds, respectively. This yielded a mean difference of 84.5 seconds, which provided a t-statistic of 8.88 (p < 0.0001).There was no evidence of a carry-over effect (p = 0.292) or a period effect (p = 0.973). All residents preferred using the Quicktrach™ kit. Use of the Quicktrach™ kit resulted in the fastest time to placement, was placed correctly in the airway, and was preferred by each of the residents. Its small, simple,and sturdy design, with few parts and easy manipulation, allow the Quicktrach™ to be a valuable option in prehospital situations involving confined spaces. The Melker™ kit, with its many parts, and need for greater manipulation, is not as easily utilized or preferred in a confined space scenario.

  19. Experience with emergency ultrasound training by Canadian emergency medicine residents.

    Science.gov (United States)

    Kim, Daniel J; Theoret, Jonathan; Liao, Michael M; Kendall, John L

    2014-05-01

    Starting in 2008, emergency ultrasound (EUS) was introduced as a core competency to the Royal College of Physicians and Surgeons of Canada (Royal College) emergency medicine (EM) training standards. The Royal College accredits postgraduate EM specialty training in Canada through 5-year residency programs. The objective of this study is to describe both the current experience with and the perceptions of EUS by Canadian Royal College EM senior residents. This was a web-based survey conducted from January to March 2011 of all 39 Canadian Royal College postgraduate fifth-year (PGY-5) EM residents. Main outcome measures were characteristics of EUS training and perceptions of EUS. Survey response rate was 95% (37/39). EUS was part of the formal residency curriculum for 86% of respondents (32/37). Residents most commonly received training in focused assessment with sonography for trauma, intrauterine pregnancy, abdominal aortic aneurysm, cardiac, and procedural guidance. Although the most commonly provided instructional material (86% [32/37]) was an ultrasound course, 73% (27/37) of residents used educational resources outside of residency training to supplement their ultrasound knowledge. Most residents (95% [35/37]) made clinical decisions and patient dispositions based on their EUS interpretation without a consultative study by radiology. Residents had very favorable perceptions and opinions of EUS. EUS training in Royal College EM programs was prevalent and perceived favorably by residents, but there was heterogeneity in resident training and practice of EUS. This suggests variability in both the level and quality of EUS training in Canadian Royal College EM residency programs. [West J Emerg Med. 2014;15(3):306-311.].

  20. Information Systems Coordinate Emergency Management

    Science.gov (United States)

    2012-01-01

    The rescue crews have been searching for the woman for nearly a week. Hurricane Katrina devastated Hancock County, the southernmost point in Mississippi, and the woman had stayed through the storm in her beach house. There is little hope of finding her alive; the search teams know she is gone because the house is gone. Late at night in the art classroom of the school that is serving as the county s emergency operations center, Craig Harvey is discussing the search with the center s commander. Harvey is the Chief Operating Officer of a unique company called NVision Solutions Inc., based at NASA s Stennis Space Center in Bay St. Louis, only a couple of miles away. He and his entire staff have set up a volunteer operation in the art room, supporting the emergency management efforts using technology and capabilities the company developed through its NASA partnerships. As he talks to the commander, Harvey feels an idea taking shape that might lead them to the woman s location. Working with surface elevation data and hydrological principles, Harvey creates a map showing how the floodwaters from the storm would have flowed along the topography of the region around the woman s former home. Using the map, search crews find the woman s body in 15 minutes. Recovering individuals who have been lost is a sad reality of emergency management in the wake of a disaster like Hurricane Katrina in 2005. But the sooner answers can be provided, the sooner a community s overall recovery can take place. When damage is extensive, resources are scattered, and people are in dire need of food, shelter, and medical assistance, the speed and efficiency of emergency operations can be the key to limiting the impact of a disaster and speeding the process of recovery. And a key to quick and effective emergency planning and response is geographic information. With a host of Earth-observing satellites orbiting the globe at all times, NASA generates an unmatched wealth of data about our ever

  1. Emergency medical dispatch codes association with emergency department outcomes.

    Science.gov (United States)

    Hettinger, A Zachary; Cushman, Jeremy T; Shah, Manish N; Noyes, Katia

    2013-01-01

    Emergency medical dispatch systems are used to help categorize and prioritize emergency medical services (EMS) resources for requests for assistance. We examined whether a subset of Medical Priority Dispatch System (MPDS) codes could predict patient outcomes (emergency department [ED] discharge versus hospital admission/ED death). This retrospective observational cohort study analyzed requests for EMS through a single public safety answering point (PSAP) serving a mixed urban, suburban, and rural community over one year. Probabilistic matching was used to link subjects. Descriptive statistics, 95% confidence intervals (CIs), and logistic regression were calculated for the 107 codes and code groupings (9E vs. 9E1, 9E2, etc.) that were used 50 or more times during the study period. Ninety percent of PSAP records were matched to EMS records and 84% of EMS records were matched to ED data, resulting in 26,846 subjects with complete records. The average age of the cohort was 46.2 years (standard deviation [SD] 24.8); 54% were female. Of the transported patients, 70% were discharged from the ED, with nine dispatch codes demonstrating a 90% or greater predictive power. Three code groupings had more than 60% predictive power for admission/death. Subjects aged 65 years and older were found to be at increased risk for admission/death in 33 dispatch codes (odds ratio [OR] 2.0 [95% confidence interval 1.3-3.0] to 19.6 [5.3-72.6]). A small subset (8% of codes; 7% by call volume) of MPDS codes were associated with greater than 90% predictive ability for ED discharge. Older adults are at increased risk for admission/death in a separate subset of MPDS codes, suggesting that age criteria may be useful to identify higher-acuity patients within the MPDS code. These findings could assist in prehospital/hospital resource management; however, future studies are needed to validate these findings for other EMS systems and to investigate possible strategies for improvements of emergency

  2. Standardized emergency management system and response to a smallpox emergency.

    Science.gov (United States)

    Kim-Farley, Robert J; Celentano, John T; Gunter, Carol; Jones, Jessica W; Stone, Rogelio A; Aller, Raymond D; Mascola, Laurene; Grigsby, Sharon F; Fielding, Jonathan E

    2003-01-01

    The smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox. A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring

  3. Surgical emergencies of the urinary tract.

    Science.gov (United States)

    McLoughlin, M A

    2000-05-01

    True emergencies of the urinary tract center on three major issues, including uncontrolled renal hemorrhage, accumulation of urine within the peritoneal cavity or retroperitoneal space, and obstruction to urine outflow. Successful management of urinary tract emergencies in small animal patients is based not only on the severity of the injury or obstruction but on the condition of the patient at the time of diagnosis and the patient's response to medical stabilization. When most urinary tract emergencies are initially recognized, patients are metabolically and hemodynamically unstable. Therefore, urinary tract emergencies are first regarded as medical emergencies, and emergency surgical procedures are aimed at patient stabilization and lifesaving measures.

  4. Integrating Emergency Services: How WA is Merging Fire and Emergency Services Agencies

    National Research Council Canada - National Science Library

    Bob, Mitchell

    1999-01-01

    Western Australia's emergency services like the Bush Fire Service, State Emergency Service and the Fire and Rescue Service is being brought together under the roof of the Fire and Emergency Services Authority (FESA) of WA...

  5. Nanotechnology risk perceptions and communication: emerging technologies, emerging challenges.

    Science.gov (United States)

    Pidgeon, Nick; Harthorn, Barbara; Satterfield, Terre

    2011-11-01

    Nanotechnology involves the fabrication, manipulation, and control of materials at the atomic level and may also bring novel uncertainties and risks. Potential parallels with other controversial technologies mean there is a need to develop a comprehensive understanding of processes of public perception of nanotechnology uncertainties, risks, and benefits, alongside related communication issues. Study of perceptions, at so early a stage in the development trajectory of a technology, is probably unique in the risk perception and communication field. As such it also brings new methodological and conceptual challenges. These include: dealing with the inherent diversity of the nanotechnology field itself; the unfamiliar and intangible nature of the concept, with few analogies to anchor mental models or risk perceptions; and the ethical and value questions underlying many nanotechnology debates. Utilizing the lens of social amplification of risk, and drawing upon the various contributions to this special issue of Risk Analysis on Nanotechnology Risk Perceptions and Communication, nanotechnology may at present be an attenuated hazard. The generic idea of "upstream public engagement" for emerging technologies such as nanotechnology is also discussed, alongside its importance for future work with emerging technologies in the risk communication field. © 2011 Society for Risk Analysis.

  6. The emergence of "emerging diseases": a lesson in holistic epidemiology.

    Science.gov (United States)

    Kilbourne, E D

    1996-01-01

    The term "emerging diseases" is a loosely defined category of entities comprising resurgent or recurrent old diseases (usually caused by "new" or mutated previously known agents), diseases truly new to man, but caused by preexisting ("old") zoonotic agents, and syndromes newly defined by the discovery of new agents through advances in biotechnology. Identification and solution of these problems depends, first, on recognition of their differences, and then upon tailoring appropriate strategies for their control. Thus, new influenza viruses appear each year to challenge immunity to their antecedents, but evoke the unchanged and centuries old symptom complex of influenza. Tuberculosis, is resurgent because of mycobacterial mutation to antibiotic resistance, immunosuppression by AIDS, and laxity in public health surveillance. Parvovirus B19 and herpesvirus 6 were revealed as cryptic infectors of white blood cells in studies of hepatitis B and AIDS, but since have been shown to be important causes of childhood rashes, aplastic anemia, and neurologic disease. The encroachment of human habitation on wilderness perimeters (ecosystem change) has increased contact with vectors of zoonotic viruses and bacteria, as evidenced by Lyme disease, Ebola virus infection, and the hemorrhagic fevers. The term "holistic epidemiology" embraces all these problems, from the molecular to the macroenvironmental level. Humans, parasites, and their environment will continue their ancient, fluctuating, dynamic relationship in the future, and new diseases will continue to emerge.

  7. Emergency medical epidemiology in Assam, India

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2009-01-01

    Full Text Available Background: Assam, with its capital in Dispur has one of the highest rates of infant and maternal mortality in India. Being under both tribal and hilly regions, it has lacked adequate healthcare and emergency services. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments, prior to launching emergency services across the state. Materials and Methods: On a prospective basis and using a stratified random sampling design, all emergencies presenting to the three government hospitals in Guwahati, Assam, which handle 90% of all emergencies currently, were studied on specially designed datasheets in order to collect data. Emergency medical technicians (EMTs were placed in the Casualty of the medical colleges and recorded all emergencies on the datasheet. The collected data was then analysed for stratification and mapping of emergencies. In addition, retrospective data for a period of 15 days was collected from the emergency case registers of all three hospitals and the adjoining district civil hospitals, in order to give a wider perspective of the nature of emergencies. Results: A total of 2169 emergencies were recorded over a seven-day prospective and fifteen-day retrospective period. Guwahati Medical College Hospital attended to majority of emergencies (42%, which were mainly of the nature of pregnancies (22.7%, accidents (12.2% or assaults (15.4% and fever related. Maximum emergencies also presented from the border districts, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents and assaults, while females presented with pregnancies as emergencies. Conclusion: Potential emergency services need to target young pregnant females. Law and order needs to be also tightened in order to curb accidents and assaults among young males.

  8. India emerging: New financial architecture

    Directory of Open Access Journals (Sweden)

    Sankarshan Basu

    2016-09-01

    Full Text Available The global financial crisis of 2007–2008 highlighted the need to re-evaluate several well established tenets in the world of finance. Questions have been raised the world over about the existing paradigm, leading to an acceptance that new financial architecture needed to be evolved and that new models need to emerge, keeping in mind the multiplicity of socio-economic realities that exist round the globe. In this context, the imperative for a new financial architecture in India is quite evident, and the ensuing panel discussion throws up some India-specific issues that need to be explored by the various stakeholders involved in this attempt.

  9. [Asthma bronchiale - Emergency medical treatment].

    Science.gov (United States)

    Hansen, Michael; Hachenberg, Thomas

    2016-06-01

    Treatment of patients with acute severe or life-threatening asthma in the emergency department or in rescue services is a challenge for the physician. The decision on which therapy is needed depends on the clinical assessment of severity. Early administration of bronchodilators, ipratropium bromide and oral or intravenous corticosteroids is the cornerstone of treatment. If these treatments fail, systemic administration of bronchodilators, MgSO4 and theophylline should be carried in order to avoid intubation. Patients with incomplete or poor response should stay in hospital. © Georg Thieme Verlag Stuttgart · New York.

  10. Change Implementation in Emerging Markets

    DEFF Research Database (Denmark)

    Thomsen, Jeanette; Sundgaard, Elin

    2010-01-01

      This paper seeks to identify the types of development changes taking place in Danish subsidiaries in Baltic countries in the accounting function. A longitudinal case study is used. The paper uses Laughlin's ‘colonizing‘ model of organizational change to understand the driving forces for change....... The knowledge of change in the Danish subsidiaries in an institutional context can help managers in subsidiaries to gain a better understanding of the overall situation and make more appropriate decisions in change implementation in subsidiaries in emerging markets. The environmental disturbance in the case...

  11. Emerging therapies in Friedreich's ataxia

    Science.gov (United States)

    Aranca, Tanya V; Jones, Tracy M; Shaw, Jessica D; Staffetti, Joseph S; Ashizawa, Tetsuo; Kuo, Sheng-Han; Fogel, Brent L; Wilmot, George R; Perlman, Susan L; Onyike, Chiadi U; Ying, Sarah H; Zesiewicz, Theresa A

    2016-01-01

    Friedreich's ataxia (FRDA) is an inherited, progressive neurodegenerative disease that typically affects teenagers and young adults. Therapeutic strategies and disease insight have expanded rapidly over recent years, leading to hope for the FRDA population. There is currently no US FDA-approved treatment for FRDA, but advances in research of its pathogenesis have led to clinical trials of potential treatments. This article reviews emerging therapies and discusses future perspectives, including the need for more precise measures for detecting changes in neurologic symptoms as well as a disease-modifying agent. PMID:26782317

  12. Emergency and Disaster Information Service

    Science.gov (United States)

    Boszormenyi, Zsolt

    2010-05-01

    The Hungarian National Association of Radio Distress-Signalling and Infocommunications (RSOE) operates Emergency and Disaster Information Service (EDIS) within the frame of its own website which has the objective to monitor and document all the events on the Earth which may cause disaster or emergency. Our service is using the speed and the data spectrum of the internet to gather information. We are monitoring and processing several foreign organisation's data to get quick and certified information. The EDIS website operated together by the General-Directorate of National Disaster Management (OKF) and RSOE, in co-operation with the Crisis Management Centre of the Ministry of Foreign Affairs, provides useful information regarding emergency situations and their prevention. Extraordinary events happening in Hungary, Europe and other areas of the World are being monitored in 24 hours per day. All events processed by RSOE EDIS are displayed real time - for the sake of international compatibility - according to the CAP protocol on a secure website. To ensure clear transparency all events are categorized separately in the RSS directory (e.g. earthquake, fire, flood, landslide, nuclear event, tornado, vulcano). RSOE EDIS also contributes in dissemination of the CAP protocol in Hungary. Beside the official information, with the help of special programs nearly 900-1000 internet press publication will be monitored and the publication containing predefined keywords will be processed. However, these "news" cannot be considered as official and reliable information, but many times we have learnt critical information from the internet press. We are screening the incoming information and storing in a central database sorted by category. After processing the information we are sending it immediately via E-Mail (or other format) for the organisations and persons who have requested it (e.g. National Disaster Management, United Nations etc.). We are aspiring that the processed data

  13. Amiodarone: an emergency medicine perspective.

    Science.gov (United States)

    Taylor, Simone E

    2002-12-01

    Amiodarone is a highly efficacious antiarrhythmic agent for many cardiac arrhythmias, ranging from atrial fibrillation to malignant ventricular rhythm disturbances. Significant interest has developed in recent years with the publication of randomized controlled trials supporting the efficacy of amiodarone over placebo and lignocaine for improving survival to hospital in patients with shock-resistant ventricular fibrillation. Amiodarone has complex pharmacological and pharmacokinetic properties. It has significant long-term adverse effects, but short-term administration of intravenous amiodarone is generally well tolerated. This article will explore issues related to the clinical use of amiodarone from an emergency medicine perspective.

  14. Emergent interfaces for feature modularization

    CERN Document Server

    Ribeiro, Márcio; Brabrand, Claus

    2014-01-01

    Developers frequently introduce errors into software systems when they fail to recognise module dependencies. Using forty-three software families and Software Product Lines (SPLs), where the majority are commonly used in industrial practice, the authors reports on the feature modularization problem and provides a study of how often it may occur in practice. To solve the problem they present the concept of emergent feature modularization which aims to establish contracts between features to prevent developers from breaking other features when performing a maintenance task.

  15. Emerging trends in ICT security

    CERN Document Server

    Akhgar, Babak

    2013-01-01

    Emerging Trends in ICT Security, an edited volume, discusses the foundations and theoretical aspects of ICT security; covers trends, analytics, assessments and frameworks necessary for performance analysis and evaluation; and gives you the state-of-the-art knowledge needed for successful deployment of security solutions in many environments. Application scenarios provide you with an insider's look at security solutions deployed in real-life scenarios, including but limited to smart devices, biometrics, social media, big data security, and crowd sourcing. Provides a multidisciplinary approach

  16. Frailty: an emerging geriatric syndrome.

    Science.gov (United States)

    Ahmed, Nasiya; Mandel, Richard; Fain, Mindy J

    2007-09-01

    Frailty is a new and emerging syndrome in the field of geriatrics. The study of frailty may provide an explanation for the downward spiral of many elderly patients after an acute illness and hospitalization. The fact that frailty is not present in all elderly persons suggests that it is associated with aging but not an inevitable process of aging and may be prevented or treated. The purpose of this article is to review what is known about frailty, including the definition, epidemiology, and pathophysiology, and to examine potential areas of future research.

  17. Emerging therapies for thyroid carcinoma.

    LENUS (Irish Health Repository)

    Walsh, S

    2012-02-01

    Thyroid carcinoma is the most commonly diagnosed endocrine malignancy. Its incidence is currently rising worldwide. The discovery of genetic mutations associated with the development of thyroid cancer, such as BRAF and RET, has lead to the development of new drugs which target the pathways which they influence. Despite recent advances, the prognosis of anaplastic thyroid carcinoma is still unfavourable. In this review we look at emerging novel therapies for the treatment of well-differentiated and medullary thyroid carcinoma, and advances and future directions in the management of anaplastic thyroid carcinoma.

  18. Emergency Operations Center ribbon cutting

    Science.gov (United States)

    2009-01-01

    Center Director Gene Goldman and special guests celebrate the opening of the site's new Emergency Operations Center on June 2. Participants included (l t r): Steven Cooper, deputy director of the National Weather Service Southern Region; Tom Luedtke, NASA associate administrator for institutions and management; Charles Scales, NASA associate deputy administrator; Mississippi Gov. Haley Barbour; Gene Goldman, director of Stennis Space Center; Jack Forsythe, NASA assistant administrator for the Office of Security and Program Protection; Dr. Richard Williams, NASA chief health and medical officer; and Weldon Starks, president of Starks Contracting Company Inc. of Biloxi.

  19. Improved Interior Emergency Lighting Study.

    Science.gov (United States)

    1983-09-01

    commercial fleet considered for this study consists of the DC-8, DC-9, DC-10, L-1011, A300, and the Boeing 727, 737, 747, 757 , and 767 aircraft. This...EMERGENCY LIGHTING ELEMENTS Aircraft Model Item DC-8 DC-9 DC-10 L-1011 A300 727 737 747 757 767 Aisles 1 1 2 2 2 1 1 2 1 2 Markers, End 16 8 24 28 32 18 4 10...in the side of the fuselage, such as ventral exit operating ian(Ile must be lf-illuni- or tail cone exits the external means of open- nated with an

  20. Therapeutic approach to electrolyte emergencies.

    Science.gov (United States)

    Schaer, Michael

    2008-05-01

    Hypokalemia, hyperkalemia, hyponatremia, hypernatremia, hypocalcemia, and hypercalcemia are commonly seen in emergency medicine. Severe abnormalities in any of these electrolytes can cause potentially life-threatening consequences to the patient. It is essential that the clinician understand and correct (if possible) the underlying cause of each disorder and recognize the importance of the rates of correction, especially with serum sodium disorders. The recommended doses in this article might have to be adjusted to the individual patient, and these modifications must be adjusted again to the pathophysiology of the primary underlying disorder.

  1. Product Innovations in Emerging Economies

    DEFF Research Database (Denmark)

    Xiao, Xiao; Sarker, Saonee; Rai, Sudhanshu

    2011-01-01

    Studies on enterprise innovations have established the relationships between a number of determinants and enterprise innovativeness. However, such studies in general have been conducted in developed economies. Recent literature has called for broadening innovation-related research to other contexts......, such as countries that are not considered “developed.” This study aims at examining how firms innovate in emerging economies. Specifically, we focus on the role of collaborative capacity in product innovations. Primary data collected from an ICT project in India has been used to test the relevant hypotheses...

  2. Building emergency medicine in Ethiopia | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2014-09-05

    Sep 5, 2014 ... Ethiopia faces a critical gap in emergency medical care. Canadian experts have paired with Addis Ababa University to develop a national research and training facility and graduate the country's first emergency medicine specialists.

  3. Building Innovation Subsidiaries in Emerging Markets

    DEFF Research Database (Denmark)

    Pogrebnyakov, Nicolai; Kristensen, Jonas D.

    2011-01-01

    Innovation subsidiaries increasingly follow manufacturing subsidiaries into emerging markets. Compared to well-established Western economies, emerging markets present unique challenges for the development of innovation management capabilities at subsidiaries. This paper distinguishes between...

  4. Emergency Wound Care After a Natural Disaster

    Science.gov (United States)

    ... Disease Transmission in Pet Shelters Protect Your Pets Emergency Wound Care After a Natural Disaster Language: English ( ... Tweet Share Compartir Print-and-Go Fact Sheet Emergency Wound Care After a Natural Disaster [NOTE: Health ...

  5. Emergency preparedness handbook for tribal governments.

    Science.gov (United States)

    2014-12-01

    Many Native American tribal governments are lacking in emergency preparedness, a part of the : emergency management cycle where planning for disasters happens. These governments need : assistance planning for future disasters. Federal, and state gove...

  6. Knowledge, Attitude and Practice of Emergency Contraception ...

    African Journals Online (AJOL)

    BACKGROUND: Emergency contraception refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure or incorrect use. Unwanted pregnancy followed by unsafe abortion can be avoided by using different contraceptive methods including emergency contraceptives.

  7. Emergency care research priorities in South Africa

    African Journals Online (AJOL)

    income countries. A manageable 'road map' for research in. South African (SA) emergency care is needed to address research gaps. Objective. To identify, collate and prioritise research topics from identified knowledge gaps in emergency care ...

  8. Enfermedades emergentes no infecciosas Emerging noninfectious diseases

    Directory of Open Access Journals (Sweden)

    Ezequiel Consiglio

    2008-11-01

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

  9. Emergency Planning and Right to Know Programs

    Science.gov (United States)

    Describes how the Emergency Planning and Community Right-to-Know Act (EPCRA) improves community access to information about chemical hazards and facilitates the development of chemical emergency response plans by tribal governments.

  10. Bedside ultrasound in pediatric emergency medicine.

    Science.gov (United States)

    Levy, Jason A; Noble, Vicki E

    2008-05-01

    Bedside emergency ultrasound has been used by emergency physicians for >20 years for a variety of conditions. In adult centers, emergency ultrasound is routinely used in the management of victims of blunt abdominal trauma, in patients with abdominal aortic aneurysm and biliary disease, and in women with first-trimester pregnancy complications. Although its use has grown dramatically in the last decade in adult emergency departments, only recently has this tool been embraced by pediatric emergency physicians. As the modality advances and becomes more available, it will be important for primary care pediatricians to understand its uses and limitations and to ensure that pediatric emergency physicians have access to the proper training, equipment, and experience. This article is meant to review the current literature relating to emergency ultrasound in pediatric emergency medicine, as well as to describe potential pediatric applications.

  11. Human factors issues in motorcoach emergency egress

    Science.gov (United States)

    2009-08-01

    FMVSS 217, Bus Emergency Exits and Window Retention and Release specifies a series of dimensional and physical requirements : for emergency exits. The intent of NHTSA is to minimize the likelihood of occupants being ejected from the bus and to pro...

  12. IRGC Guidelines for Emerging Risk Governance (Appendix)

    OpenAIRE

    Mazri, Chabane; Florin, Marie-Valentine

    2015-01-01

    This appendix to IRGC's main report "guidelines for emerging risk governance" provides (a) a review of existing framework for the governance of emerging risks and (b) a review of theoretical foundations of IRGC's guidelines.

  13. Emergency contraception, efficacy and public health impact.

    Science.gov (United States)

    Broekhuizen, Fredrik F

    2009-08-01

    Emergency contraception in the past two decades had been proven to be effective and well tolerated. Counseling and advance provision and prescription of emergency contraception have been embraced by professional organizations in practice guidelines for its potential to reduce the number of unintended pregnancies and abortions. Has emergency contraception lived up to that promise? Mifepristone (not available in the USA) is the agent of choice. Emergency contraception has not reduced the number of unintended pregnancies. Acceptance by healthcare providers and the public has not been optimal, and multiple financial and healthcare system barriers to use emergency contraception continue to exist. The public health impact of emergency contraception has been disappointing. Although emergency contraception may continue to be an important component of contraceptive practice, only increased access to more effective methods of contraception will change unintended pregnancy rates. The use of mifepristone for emergency contraception in the USA must be considered.

  14. Spatial Spillovers in Emerging Market Spreads

    OpenAIRE

    Salvatore Dell'Erba; Emanuele Baldacci; Tigran Poghosyan

    2011-01-01

    We use novel spatial econometrics techniques to explore spillovers in the sovereign bond market for 24 emerging economies during 1995-2010. The paper extends the previous literature focusing on spillover effects from advanced to emerging economies by analyzing transmission of shocks across emerging markets. After controlling for the impact of global factors, we find strong evidence of spillovers from both sovereign spreads and macroeconomic fundamentals in neighboring emerging economies. In a...

  15. Emergency contraception: Focus on the facts.

    Science.gov (United States)

    Najera, Deanna Bridge

    2016-01-01

    Significant progress on contraception, and in particular emergency contraception, has been made in the past decade. Emergency contraception was first introduced as a stand-alone prescription in 1998, and the interaction of politics and medicine meant a tumultuous course to the drug becoming available over the counter. This article reviews how emergency contraception works, the effectiveness of different methods, pros and cons, and the history of emergency contraception.

  16. [Shoulder dystocia: an obstetrical emergency].

    Science.gov (United States)

    Marques, Joana Borges; Reynolds, Ana

    2011-01-01

    Shoulder dystocia is one of the most feared obstetric emergencies due to related maternal and neonatal complications and therefore, the growing of medico-legal litigation that it entails. Although associated with risk factors such as fetal macrossomia, gestacional diabetes and instrumented delivery, the majority of cases are unpredictable. The lack of a consensus on shoulder dystocia diagnosis causes variations on its incidence and hampers a more comprehensive analysis. Management guidelines described for its resolution include several manoeuvres but the ideal sequence of procedures is not clearly defined in more severe cases. Hands-on and team training, through simulation-based techniques applied to medicine, seems to be a promising method to learn how to deal with shoulder dystocia having in mind a reduction in related maternal or neonatal morbidity and mortality. The main goal of this paper is to provide a comprehensive revision of shoulder dystocia highlighting its relevance as an obstetric emergency. A reflection on the management is presented emphasising the importance of simulation-based training.

  17. Cost analysis of emergency department.

    Science.gov (United States)

    Cremonesi, P; Di Bella, E; Montefiori, M

    2010-12-01

    This paper is intended to examine both clinical and economic data concerning the activity of an emergency department of an Italian primary Hospital. Real data referring to arrivals, waiting times, service times, severity (according to triage classification) of patients' condition collected along the whole 2009 are matched up with the relevant accounting and economic information concerning the costs faced. A new methodological approach is implemented in order to identify a "standard production cost" and its variability. We believe that this kind of analysis well fits the federalizing process that Italy is experiencing. In fact the federal reform is driving our Country toward a decentralized provision and funding of local public services. The health care services are "fundamental" under the provisions of the law that in turn implies that a standard cost has to be defined for its funding. The standard cost (as it is defined by the law) relies on the concepts of appropriateness and efficiency in the production of the health care service, assuming a standard quality level as target. The identification and measurement of health care costs is therefore a crucial task propaedeutic to health services economic evaluation. Various guidelines with different amount of details have been set up for costing methods which, however, are defined in simplified frameworks and using fictious data. This study is a first attempt to proceed in the direction of a precise definition of the costs inherent to the emergency department activity.

  18. Emerging management strategies for obesity.

    Science.gov (United States)

    Kopelman, P G

    1998-08-01

    Management strategies for obesity, which include drug therapy, are emerging as a consequence of the increasing recognition of the medical seriousness of obesity. Obesity requires appropriate and effective management by suitably trained members of a multidisciplinary team, with treatment programmes putting equal importance on weight reduction and its maintenance. Such programmes must also take into account the reduction in risk from co-morbid conditions after modest weight loss (5-10% of initial body weight). The use of an anti-obesity drug may be justified for patients at risk from obesity where dietary methods, including exercise and behaviour modification, have failed to achieve a 10% reduction in initial body weight after at least three months from the start of the episode of managed care. Anti-obesity drugs must be prescribed in an appropriate setting, with patients being reviewed on a regular basis. Essential elements for managed weight loss include, a printed management programme, appropriate equipment, specified and realistic weight-loss goals, documentation of individual patient's health risks, and clearly defined follow-up procedures with explicit guidelines for the use of drugs and notification of other doctors involved in the patient's care. The process of drug treatment necessitates a system of regular medical audit. Many health-care professionals and lay persons remain sceptical about the scientific value of anti-obesity drugs. The emergence of increasingly specific and effective agents underlines the importance of ensuring appropriate use for patients at risk from obesity.

  19. HDL, Atherosclerosis, and Emerging Therapies

    Directory of Open Access Journals (Sweden)

    Anouar Hafiane

    2013-01-01

    Full Text Available This review aims to provide an overview on the properties of high-density lipoproteins (HDLs and their cardioprotective effects. Emergent HDL therapies will be presented in the context of the current understanding of HDL function, metabolism, and protective antiatherosclerotic properties. The epidemiological association between levels of HDL-C or its major apolipoprotein (apoA-I is strong, graded, and coherent across populations. HDL particles mediate cellular cholesterol efflux, have antioxidant properties, and modulate vascular inflammation and vasomotor function and thrombosis. A link of causality has been cast into doubt with Mendelian randomization data suggesting that genes causing HDL-C deficiency are not associated with increased cardiovascular risk, nor are genes associated with increased HDL-C, with a protective effect. Despite encouraging data from small studies, drugs that increase HDL-C levels have not shown an effect on major cardiovascular end-points in large-scale clinical trials. It is likely that the cholesterol mass within HDL particles is a poor biomarker of therapeutic efficacy. In the present review, we will focus on novel therapeutic avenues and potential biomarkers of HDL function. A better understanding of HDL antiatherogenic functions including reverse cholesterol transport, vascular protective and antioxidation effects will allow novel insight on novel, emergent therapies for cardiovascular prevention.

  20. HDL, Atherosclerosis, and Emerging Therapies.

    Science.gov (United States)

    Hafiane, Anouar; Genest, Jacques

    2013-01-01

    This review aims to provide an overview on the properties of high-density lipoproteins (HDLs) and their cardioprotective effects. Emergent HDL therapies will be presented in the context of the current understanding of HDL function, metabolism, and protective antiatherosclerotic properties. The epidemiological association between levels of HDL-C or its major apolipoprotein (apoA-I) is strong, graded, and coherent across populations. HDL particles mediate cellular cholesterol efflux, have antioxidant properties, and modulate vascular inflammation and vasomotor function and thrombosis. A link of causality has been cast into doubt with Mendelian randomization data suggesting that genes causing HDL-C deficiency are not associated with increased cardiovascular risk, nor are genes associated with increased HDL-C, with a protective effect. Despite encouraging data from small studies, drugs that increase HDL-C levels have not shown an effect on major cardiovascular end-points in large-scale clinical trials. It is likely that the cholesterol mass within HDL particles is a poor biomarker of therapeutic efficacy. In the present review, we will focus on novel therapeutic avenues and potential biomarkers of HDL function. A better understanding of HDL antiatherogenic functions including reverse cholesterol transport, vascular protective and antioxidation effects will allow novel insight on novel, emergent therapies for cardiovascular prevention.

  1. Caring in pediatric emergency nursing.

    Science.gov (United States)

    Gillespie, Gordon Lee; Hounchell, Melanie; Pettinichi, Jeanne; Mattei, Jennifer; Rose, Lindsay

    2012-01-01

    An environment committed to providing family-centered care to children must be aware of the nurse caring behaviors important to parents of children. This descriptive study assessed the psychometrics of a revised version of the Caring Behaviors Assessment (CBA) and examined nurse caring behaviors identified as important to the parents of pediatric patients in a pediatric emergency department. Jean Watson's theory of human caring provided the study's theoretical underpinnings. The instrument psychometrics was determined through an index of content validity (CVI) and internal consistency reliability. The instrument was determined to be valid (CVI = 3.75) and reliable (Cronbach's alpha = .971). The revised instrument was completed by a stratified, systematic random sample of 300 parents of pediatric emergency patients. Participants rated the importance of each item for making the child feel cared for by nurses. Individual survey item means were computed. Items with the highest means represented the most important nurse caring behaviors. Leading nurse caring behaviors centered on carative factors of "human needs assistance" and "sensitivity to self and others." Nearly all nurse caring behaviors were important to the parents of pediatric patients, although some behaviors were not priority. It is important for nurses to provide family-centered care in a way that demonstrates nurse caring.

  2. Emerging pharmaceutical therapies for COPD.

    Science.gov (United States)

    Lakshmi, Sowmya P; Reddy, Aravind T; Reddy, Raju C

    2017-01-01

    COPD, for which cigarette smoking is the major risk factor, remains a worldwide burden. Current therapies provide only limited short-term benefit and fail to halt progression. A variety of potential therapeutic targets are currently being investigated, including COPD-related proinflammatory mediators and signaling pathways. Other investigational compounds target specific aspects or complications of COPD such as mucus hypersecretion and pulmonary hypertension. Although many candidate therapies have shown no significant effects, other emerging therapies have improved lung function, pulmonary hypertension, glucocorticoid sensitivity, and/or the frequency of exacerbations. Among these are compounds that inhibit the CXCR2 receptor, mitogen-activated protein kinase/Src kinase, myristoylated alanine-rich C kinase substrate, selectins, and the endothelin receptor. Activation of certain transcription factors may also be relevant, as a large retrospective cohort study of COPD patients with diabetes found that the peroxisome proliferator-activated receptor γ (PPARγ) agonists rosiglitazone and pioglitazone were associated with reduced COPD exacerbation rate. Notably, several therapies have shown efficacy only in identifiable subgroups of COPD patients, suggesting that subgroup identification may become more important in future treatment strategies. This review summarizes the status of emerging therapeutic pharmaceuticals for COPD and highlights those that appear most promising.

  3. Emerging infectious diseases: Epidemiological perspective

    Directory of Open Access Journals (Sweden)

    Shuvankar Mukherjee

    2017-01-01

    Full Text Available Over the past 30 years, at least 30 new infectious diseases have emerged to threaten the health of millions of people across the globe. The major challenge to combat these infections is that for many of them, there is no specific treatment or cure or vaccine. There is limited scope of preventing or controlling them. The contributory factors include urbanization and destruction of natural habitats, climate change and changing ecosystems, changes in population of reservoir hosts or intermediate insect vectors and microbial genetic mutation, international trade and commerce, change in human demographics and behavior, lack of public health services and infrastructure, and antibiotic resistance. It is clear by now that the problem of emerging infectious disease (EID is not restricted to any single country, and a strong and sustainable international collaboration will be needed in their prevention and control. India along with other countries in the South-East Asian region will continue to bear the brunt of the burden of EIDs in years to come.

  4. Emerging drugs for prostate cancer.

    Science.gov (United States)

    Chung, Paul H; Gayed, Bishoy A; Thoreson, Gregory R; Raj, Ganesh V

    2013-12-01

    Androgen deprivation therapy is the mainstay treatment for patients with prostate cancer who are not candidates for definitive treatment, are diagnosed with advanced disease on initial presentation or progress after primary treatment. Patients who stop responding to androgen deprivation therapy develop castration resistant prostate cancer (CRPC). Emerging drugs undergoing clinical evaluation and drugs that have recently received FDA approval for the treatment of CRPC are reviewed. As the natural history and signaling pathways of prostate cancer are better understood, new treatments and targeted therapies will be developed. The FDA recently approved 5 medications that increase survival in patients with CRPC. Additional medications and drug classes are being explored that may eventually lead to new treatment options. Articles were identified using a PubMed database search. Recent FDA medication approvals and the development of emerging treatments are promising for the future of patients with prostate cancer. The addition of new medications challenges physicians to identify the optimal sequence and/or combination in which newer and older medications should be administered. Physicians treating patients with prostate cancer have a growing responsibility to keep pace with these new medications so that they may counsel and treat patients appropriately.

  5. INSTITUTIONAL CHANGES IN EMERGING EUROPE

    Directory of Open Access Journals (Sweden)

    Oana Georgiana AMARANDEI

    2015-08-01

    Full Text Available The recent global economic crisis has created new conditions and situations for the economic environment and therefore, in this context the rethinking of the institutional system is mandatory. The present paper seeks to propose an empirical model and aims at capturing the interdependencies between the institutional changes and the economic progress in the European emerging countries, in order to emphasize that institutions are the key elements in the process of economic growth. After briefly reviewing the most relevant literatures that have documented the variety of the institutional changes, the paper focuses on the amplitude of the phenomena of institutional changes from the  European emerging countries. The research tries to establish a “stimulus – effect” relationship between the changing of the institutional environment and the rate of economic growth and human development. The conclusions for the methodological aspects illustrate that the level of social and economic development is a natural result of the quality of the institutional environment.

  6. knowledge, attitude and practice of emergency contraceptives

    African Journals Online (AJOL)

    GB

    emergency contraception among was only 4.7%. Emergency contraceptive pills were the commonest. EC method used which accounted for 23(74.2%) (table. 3). Table 3: Knowledge, attitude and practice about emergency contraceptives among female university students; Adama. University, Ethiopia, February, 2009.

  7. Emergency Contraception: A Wareness And Knowledge Among ...

    African Journals Online (AJOL)

    Most of the hospital workers were not aware of emergency contraceptive methods. 59.9% were not aware of emergency contraceptive pills, while 81.4% were not aware of the use of intrauterine contraceptive device. Medical and Paramedical workers show more awareness about emergency contraception than non-medical ...

  8. 27 CFR 44.112 - Emergency premises.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Emergency premises. 44.112 Section 44.112 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... Warehouse Proprietors Changes in Location and Premises § 44.112 Emergency premises. In cases of emergency...

  9. 38 CFR 17.1003 - Emergency transportation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

  10. 76 FR 766 - Amtrak Emergency Routing Orders

    Science.gov (United States)

    2011-01-06

    ... Surface Transportation Board 49 CFR Parts 1011, 1034, 1102, 1104, and 1115 Amtrak Emergency Routing Orders... Transportation Board (Board or STB) proposes to establish regulations governing the issuance of emergency routing... regulations governing the issuance of emergency routing orders upon application of the National Railroad...

  11. 46 CFR 169.711 - Emergency lighting.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency lighting. 169.711 Section 169.711 Shipping... Control, Miscellaneous Systems, and Equipment § 169.711 Emergency lighting. (a) Each vessel must be... satisfy the emergency lighting requirements for a miscellaneous self-propelled vessel as contained in part...

  12. 49 CFR 238.115 - Emergency lighting.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Emergency lighting. 238.115 Section 238.115... § 238.115 Emergency lighting. (a) This section applies to each passenger car ordered on or after... applies to each level of a multi-level passenger car. (b) Emergency lighting shall be provided in each...

  13. 46 CFR 129.440 - Emergency lighting.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Emergency lighting. 129.440 Section 129.440 Shipping... INSTALLATIONS Lighting Systems § 129.440 Emergency lighting. (a) A vessel of less than 100 gross tons must have adequate emergency lighting fitted along the line of escape to the main deck from accommodations and...

  14. 46 CFR 183.432 - Emergency lighting.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency lighting. 183.432 Section 183.432 Shipping...) ELECTRICAL INSTALLATION Lighting Systems § 183.432 Emergency lighting. (a) Each vessel must have adequate emergency lighting fitted along the line of escape to the main deck from all passenger and crew...

  15. 14 CFR 25.812 - Emergency lighting.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Emergency lighting. 25.812 Section 25.812... lighting. (a) An emergency lighting system, independent of the main lighting system, must be installed... lighting systems if the power supply to the emergency lighting system is independent of the power supply to...

  16. 46 CFR 120.432 - Emergency lighting.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Emergency lighting. 120.432 Section 120.432 Shipping... PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS ELECTRICAL INSTALLATION Lighting Systems § 120.432 Emergency lighting. (a) Each vessel must have adequate emergency lighting fitted along...

  17. 77 FR 25375 - Emergency Planning Zone

    Science.gov (United States)

    2012-04-30

    ... COMMISSION 10 CFR Parts 50 and 52 Emergency Planning Zone AGENCY: Nuclear Regulatory Commission. ACTION... requests that the NRC amend its regulations to expand the Emergency Planning Zones (EPZs) for nuclear power... power plants and who are concerned that current NRC emergency planning requirements are not adequate to...

  18. 10 CFR 76.91 - Emergency planning.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Emergency planning. 76.91 Section 76.91 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Safety § 76.91 Emergency planning... Emergency Planning and Community Right-to-Know Act of 1986, Title III, Public Law 99-499, or other State or...

  19. 40 CFR 164.123 - Emergency order.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Emergency order. 164.123 Section 164... Hearings § 164.123 Emergency order. (a) Whenever the Environmental Appeals Board determines that an emergency exists that does not permit him to hold a hearing before suspension, the Environmental Appeals...

  20. 15 CFR 705.9 - Emergency action.

    Science.gov (United States)

    2010-01-01

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