WorldWideScience

Sample records for understood emerging evidence

  1. How is evidence to be understood in modern coaching psychology?

    DEFF Research Database (Denmark)

    Spaten, Ole Michael; Løkken, Lillith Olesen

    2015-01-01

    The hunt for evidence in modern coaching psychology could be counter-productive, and possibly lead to a simplified approach to research, practice, searching for “definitive truths”. The article discuss a critical approach to evidence hierarchies, and the prevalent (medical) understanding...

  2. Opportunities to preserve forensic evidence in emergency departments.

    Science.gov (United States)

    Peel, Matthew

    2016-11-10

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

  3. Pathological Overeating: Emerging Evidence for a Compulsivity Construct.

    Science.gov (United States)

    Moore, Catherine F; Sabino, Valentina; Koob, George F; Cottone, Pietro

    2017-06-01

    Compulsive eating behavior is a transdiagnostic construct that is characteristic of medical and psychiatric conditions such as forms of obesity and eating disorders. Although feeding research is moving toward a better understanding of the proposed addictive properties of food, the components and the mechanisms contributing to compulsive eating are not yet clearly defined or understood. Current understanding highlights three elements of compulsive behavior as it applies to pathological overeating: (1) habitual overeating; (2) overeating to relieve a negative emotional state; and (3) overeating despite aversive consequences. These elements emerge through mechanisms involving pathological habit formation through an aberrant learning process, the emergence of a negative emotional state, and dysfunctions in behavioral control. Dysfunctions in systems within neurocircuitries that comprise the basal ganglia, the extended amygdala, and the prefrontal cortex result in compulsive eating behaviors. Here, we present evidence to relate compulsive eating behavior and addiction and to characterize their underlying neurobiological mechanisms. A major need to improve understanding of compulsive eating through the integration of complex motivational, emotional, and cognitive constructs is warranted.

  4. Poorly Understood Aspects of Striated Muscle Contraction

    Directory of Open Access Journals (Sweden)

    Alf Månsson

    2015-01-01

    Full Text Available Muscle contraction results from cyclic interactions between the contractile proteins myosin and actin, driven by the turnover of adenosine triphosphate (ATP. Despite intense studies, several molecular events in the contraction process are poorly understood, including the relationship between force-generation and phosphate-release in the ATP-turnover. Different aspects of the force-generating transition are reflected in the changes in tension development by muscle cells, myofibrils and single molecules upon changes in temperature, altered phosphate concentration, or length perturbations. It has been notoriously difficult to explain all these events within a given theoretical framework and to unequivocally correlate observed events with the atomic structures of the myosin motor. Other incompletely understood issues include the role of the two heads of myosin II and structural changes in the actin filaments as well as the importance of the three-dimensional order. We here review these issues in relation to controversies regarding basic physiological properties of striated muscle. We also briefly consider actomyosin mutation effects in cardiac and skeletal muscle function and the possibility to treat these defects by drugs.

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

    Science.gov (United States)

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

    2012-07-23

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

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

    Directory of Open Access Journals (Sweden)

    Challen Kirsty

    2012-07-01

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

  7. Emergent Writing in Preschoolers: Preliminary Evidence for a Theoretical Framework

    Science.gov (United States)

    Puranik, Cynthia S.; Lonigan, Christopher J.

    2014-01-01

    Researchers and educators use the term emergent literacy to refer to a broad set of skills and attitudes that serve as foundational skills for acquiring success in later reading and writing; however, models of emergent literacy have generally focused on reading and reading-related behaviors. Hence, the primary aim of this study was to articulate and evaluate a theoretical model of the components of emergent writing. Alternative models of the structure of individual and developmental differences of emergent writing and writing-related skills were examined in 372 preschool children who ranged in age from 3- to 5-years using confirmatory factor analysis. Results from a confirmatory factor analysis provide evidence that these emergent writing skills are best described by three correlated but distinct factors, (a) Conceptual Knowledge, (b) Procedural Knowledge, and (c) Generative Knowledge. Evidence that these three emergent writing factors show different patterns of relations to emergent literacy constructs is presented. Implications for understanding the development of writing and assessment of early writing skills are discussed. PMID:25316955

  8. Socialization understood in a dynamic way

    Directory of Open Access Journals (Sweden)

    Todorović Milorad R.

    2017-01-01

    Full Text Available In psychology, the process of socialization often gets the meaning it does not actually have and it also gets attached to things that are related to other processes. Here, socialization is understood only as the entering of a subject into a socio-symbolic order where he acquires his own identity. This entering into a separating order places the good on one side, and the bad on the other, and it is essentially a process that strongly designates the world by giving a man's instinctive nature the social contours obtained through imposed standards. Every form of anti-social behaviour, as well as every great psychological deviation, shows the lack of proper integration into the symbolic. Psychology, as a general theory of the psyche, and social psychology especially, indicates the social and cultural conditions that influence the mental construction. Without the dynamics of psychology, which depicts the psychological life through mental dynamics, psychological etiologies especially of those forms of behaviour that have no social verification would be neglected. Starting from the social and cultural conditions that build the 'psychological', it explains how the motives for suppression of all impulsive tendencies, aggression and libido are built. Mastering the impulses involves the construction of a moral instance (super-ego that differentiates and exists as a constant threat to the ego who tries to smuggle certain instinctive tendencies. Given that it is known, ever since Freud, that - from the standpoint of limiting the impulses, from the standpoint of morality - a man has a completely immoral part (instinctive, id; a part that is struggling to be moral (ego; and a super-ego that can be hyper-moral, and then become utterly cruel (Freud 2006a: 120, it can be observed that socialization is involved in the good part and in the bad part of a man. Success in a man's defense from Eros and Thanatos, on the one hand, and in his defense from the impulses of

  9. Emerging Evidence for Platelets as Immune and Inflammatory Effector Cells

    Directory of Open Access Journals (Sweden)

    Matthew Thomas Rondina

    2014-12-01

    Full Text Available While traditionally recognized for their roles in hemostatic pathways, emerging evidence demonstrates that platelets have previously unrecognized, dynamic roles that span the immune continuum. These newly-recognized platelet functions, including the secretion of immune mediators, interactions with endothelial cells, monocytes, and neutrophils, toll-like receptor (TLR mediated responses, and induction of neutrophil extracellular trap (NET formation, bridge thrombotic and inflammatory pathways and contribute to host defense mechanisms against invading pathogens. In this focused review, we highlight several of these emerging aspects of platelet biology and their implications in clinical infectious syndromes.

  10. The role of Victorian emergency nurses in the collection and preservation of forensic evidence: a review of the literature.

    Science.gov (United States)

    McGillivray, Bree

    2005-04-01

    Emergency Departments (ED) are providing care for increasing numbers of patients who present as a result of criminal or interpersonal violence and patients may be victims, suspects or perpetrators. As a result, the role of emergency nurses in the recognition, collection and preservation of forensic evidence is increasing. There is little published literature about the role and responsibilities of emergency nurses regarding the collection and preservation of evidence in the state of Victoria and this is complicated by a lack of department and organisation policy and the need for more specific educational preparation of emergency nurses in this area. While it is well accepted that the primary focus of nursing care will always be the physical and emotional care of the patient, the increasing importance of the role of emergency nurses in the recognition and collection of forensic evidence in Victoria is now being recognized and the need for education of emergency nurses in this area understood. This paper reviews the literature related to the recognition, collection and preservation, of forensic materials in EDs by emergency nurses in the state of Victoria and discusses the role of emergency nurses in Victoria in caring for patients who present as victims of violence and in whom the collection and preservation of forensic evidence is required.

  11. Donors in Semiconductors - are they Understood in Electronic Era?

    International Nuclear Information System (INIS)

    Dmochowski, Janusz E

    2007-01-01

    The physics of semiconductors and contemporary electronics cannot be understood without impurities. The hydrogen-like shallow donor (and acceptor) state of electron (hole) bound by Coulomb electrostatic force of excess charge of impurity is used to control conductivity of semiconductors and construct semiconductor diodes, transistors and numerous types of semiconductor electronic and optoelectronic devices, including lasers. Recently, surprisingly, the physics of impurity donors appeared to be much reacher. Experimental evidence has been provided for universal existence of other types of electronic states of the same donor impurity: i) mysterious, deep, DX-type state resulting in metastability - slow hysteresis phenomena - understood as two-electron, acceptor-like state of donor impurity, formed upon large lattice distortion or rearrangement around impurity and accompanying capture of second electron, resulting in negative electron correlation energy U; ii) deep, localized, fully symmetric, A1, one-electron donor state of substitutional impurity. The latter state can be formed from the 'ordinary' shallow hydrogen-like state in the process of strong localization of electron by short range, local potential of impurity core, preserving full (A 1 ) symmetry of the substitutional impurity in the host lattice. The 'anticrossing' of the two A 1 (shallow hydrogenic and deep localized) energy levels upon transformation is observed. All types of electronic states of impurity can be universally observed for the same donor impurity and mutual transformation between different states occur upon changing experimental conditions. The knowledge about existence and properties of these n ew , molecular type, donor states in semiconductors seems still await general recognition and positive application in contemporary material and device science and engineering

  12. Dual protection: more needed than practised or understood.

    Science.gov (United States)

    Berer, Marge

    2006-11-01

    Although non-barrier contraceptive use has become a global norm, unprotected sex in relation to sexually transmitted infections remains the norm almost everywhere. Dual protection is protection from unwanted pregnancy, HIV and other sexually transmitted infections, and is a form of safer sex for heterosexual couples that is more needed than practised or understood. This paper draws on a review of the literature in family planning, obstetrics and gynaecology, and AIDS-related journals from 1998 to early 2005. Definitions of dual protection, found mainly in family planning literature, are very narrow. Condoms remain the mainstay of dual protection, but the aim of this paper is to provide an expanded list of dual protection methods to show that there is a range of options. These include non-penetrative sex and the increasing use of condoms with the back-up of emergency contraception on the part of young people. The fact that people may fail to use dual protection consistently and correctly is not a valid reason not to promote it. It is never too late for those providing family planning and STI/HIV prevention services to start promoting condoms and dual protection. In the long-term, the development of highly efficacious and highly acceptable methods of dual protection is an urgent research priority, starting with a wider range of condoms that will appeal to more people.

  13. Improving Evidence on Private Giving in Emerging Economies ...

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

    ... gaps on amounts and sources. There is also a lack of research on regulations and policies that support or discourage private giving. This research project will explore philanthropic cooperation in emerging and developing country contexts by quantifying financial flows from emerging economies to developing countries.

  14. Stocks for the long run? : Evidence from emerging markets

    NARCIS (Netherlands)

    Spierdijk, Laura; Umar, Zaghum

    2014-01-01

    We estimate the myopic (single-period) and intertemporal hedging (long-run) demand for stocks in 20 growth-leading emerging market economies during the 1999-2012 period. We consider two types of investors: a domestic investor who invests in emerging-market assets only (with returns in local

  15. Multimarket contact and performance: Evidence from emerging economies

    Directory of Open Access Journals (Sweden)

    Beatriz Domínguez

    2016-10-01

    Full Text Available The organizational structure of multinational enterprises (MNEs is mainly made up of subsidiaries located in emerging and advanced countries. Consequently, they usually compete against the same rivals simultaneously in both emerging and advanced contexts. Multimarket contact (MMC theory analyzes the competitive dynamics that arise in these situations. However, researchers have paid more attention to the consequences of multimarket contact in developed countries than to its effect in emerging countries. To explore the impact of the macroenvironment on the relationship between MMC and performance, we examine how coinciding with multimarket rivals in emerging economies alters the effect of MMC on firm performance. Our research, which is developed with a sample from the mobile telecommunications industry, shows that the presence of MNEs in emerging countries hinders the development of mutual forbearance practices and, therefore, reduces the positive effect of MMC on firm performance.

  16. Implementing evidence-based practices in an emergency department

    DEFF Research Database (Denmark)

    Kirk, Jeanette W.; Nilsen, Per

    2016-01-01

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

  17. Children's Graphical Representations and Emergent Writing: Evidence from Children's Drawings

    Science.gov (United States)

    Wu, Li-Yuan

    2009-01-01

    Previous research on children's drawing and writing focused on children's drawing and symbolization with syllabic languages, providing little information regarding young children's symbolization in drawing with a logo language. This study investigated children's emergent writing by examining qualitatively how children's writing takes place as…

  18. Psychological Benefits of Regular Physical Activity: Evidence from Emerging Adults

    Science.gov (United States)

    Cekin, Resul

    2015-01-01

    Emerging adulthood is a transitional stage between late adolescence and young adulthood in life-span development that requires significant changes in people's lives. Therefore, identifying protective factors for this population is crucial. This study investigated the effects of regular physical activity on self-esteem, optimism, and happiness in…

  19. Feeling (Mis)Understood and Intergroup Friendships in Interracial Interactions.

    Science.gov (United States)

    Shelton, Nicole; Douglass, Sara; Garcia, Randi L; Yip, Tiffany; Trail, Thomas E

    2014-09-01

    The present research investigated whether having out-group friends serves as a buffer for feeling misunderstood in interracial interactions. Across three experience sampling studies, we found that among ethnic minorities who have few White friends or are not interacting with White friends, daily interracial interactions are associated with feeling less understood. By contrast, we found that among ethnic minorities who have more White friends or are interacting with White friends, the relationship between daily interracial interactions and feeling understood is not significant. We did not find similar results for Whites; that is, having ethnic minority friends did not play a role in the relationship between daily interracial interactions and feeling understood. Together, these studies demonstrate the beneficial effects of intergroup friendships for ethnic minorities. © 2014 by the Society for Personality and Social Psychology, Inc.

  20. Efficient Market Hypothesis: Some Evidences from Emerging European Forex Markets

    OpenAIRE

    Anoop S Kumar; Bandi Kamaiah

    2014-01-01

    This study attempts to analyze the presence of weak form efficiency in the forex markets of a set of select European emerging markets namely Bulgaria, Croatia, Czech Republic, Hungary Poland, Romania, Russia, Slovakia and Slovenia using the monthly NEER data ranging from jan-1994 to Dec-2013. We employ a two step comprehensive methodology where in the first place we test for weak form efficiency using a family of individual and joint variance ratio tests. The results show that while the marke...

  1. How self-reliance is understood: viewpoints from one local ...

    African Journals Online (AJOL)

    How self-reliance is understood: viewpoints from one local community in Malawi. ... model that resists dependence on external aid, empowers community development, and provides opportunities to sustain development activity through local initiative, can be employed to increase social capital leading to sustainable growth.

  2. The emergence of the parol evidence rule in English law

    OpenAIRE

    Jarosz, Iwo

    2016-01-01

    Artykuł niniejszy omawia historyczny rozwój parol evidence rule (czyli reguły prawa materialnego zakazującej sądom dopuszczania na okoliczność treści bądź wykładni dokumentu extrinsic evidence, czyli dowodów innych niż sam dokument) w angielskim common law od czasów prawa anglo-normańskiego aż do uchwalenia w 1677 r. Statute of Frauds. Wczesne prawo angielskie charakteryzowała ogólna dopuszczalność takich dowodów. Dokumenty pisemne nie cieszyły się zaufaniem niepiśmiennej społeczności, uważan...

  3. Financialization at the international level: evidence from emerging market economies

    Directory of Open Access Journals (Sweden)

    Raquel A. Ramos

    Full Text Available Abstract The paper focuses on the manifestations of financialization in the international sphere, which it defines as the increasing magnitude of finance and its decoupling from earlier functions and logic as the speculative motive is strengthened. With financialization the motive of finance is no longer to finance trade and production but to accumulate wealth, which in emerging market economies (EMEs takes place through innovative products and practices that have in common the focus on exchange rate returns, resulting in a strengthened speculative motive. The article reviews the financialization literature highlighting how the different closed-economy aspects impact the international sphere. It conducts empirical analyses based on the financial integration of a country and on the characteristics of its currencies’ FX markets to assess the presence of financialization and its characteristics among EMEs, indicating certain countries where this process is more intense.

  4. Evidence for a complex of emergent poleroviruses affecting pepper worldwide.

    Science.gov (United States)

    Fiallo-Olivé, Elvira; Navas-Hermosilla, Elisa; Ferro, Camila G; Zerbini, F Murilo; Navas-Castillo, Jesús

    2018-05-01

    In recent years, symptoms of vein yellowing and leaf roll in pepper crops associated with the presence of poleroviruses (genus Polerovirus, family Luteoviridae) have been emerging in many countries worldwide. Spain was the first country in Europe where the yellowing disease of pepper was observed. In this work, a polerovirus isolate from Spain that infects pepper and has been shown to be transmitted by the aphid Aphis gossyppii (Spain-Almería 2-2013) was sequenced and compared with isolates from Japan, Israel, China and Australia. The genome (6125 nt in length, GenBank accession number KY523072) of the isolate from Spain has the typical organization of poleroviruses and contains seven open reading frames (ORF0 to ORF5 and ORF3a), putatively encoding proteins P0 to P5 and P3a. A comparison of the sequence from Spain with the four complete sequences available for poleroviruses infecting pepper showed a closer relationship to the isolate from Israel and supports the existence of a complex of at least five polerovirus species. Given that the symptoms caused by all pepper poleroviruses described to date are similar, if not identical, we propose to name them "pepper vein yellows virus 1" to "pepper vein yellows virus 5" (PeVYV-1 to PeVYV-5), with PeVYV-5 corresponding to the polerovirus from Spain described in this work. Our results and those published over the last few years have shown that the emergent poleroviruses threatening pepper crops around the world are highly complex due to recombination events.

  5. Urachal tumour: case report of a poorly understood carcinoma

    Directory of Open Access Journals (Sweden)

    Vallarino Luigi

    2009-11-01

    Full Text Available Abstract Background Urachal carcinoma is an uncommon neoplasm associated with poor prognosis. Case presentation A 45-year-old man was admitted with complaints of abdominal pain and pollakisuria. A soft mass was palpable under his navel. TC-scan revealed a 11 × 6 cm tumor, which was composed of a cystic lesion arising from the urachus and a solid mass component at the urinary bladder dome. The tumor was removed surgically. Histological examination detected poor-differentiated adenocarcinoma, which had invaded the urinary bladder. The patient has been followed up without recurrence for 6 months. Conclusion The urachus is the embryological remnant of urogenital sinus and allantois. Involution usually happens before birth and urachus is present as a median umbilical ligament. The pathogenesis of urachal tumours is not fully understood. Surgery is the treatment of choice and role of adjuvant treatment is not clearly understood.

  6. Treatment of Graves' hyperthyroidism: evidence-based and emerging modalities

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo

    2009-01-01

    Currently there are three well-established treatment options for hyperthyroid Graves' disease (GD): antithyroid drug therapy with thionamides (ATD), radioactive iodine treatment with (131)I, and thyroid surgery. This article reviews the current evidence so the reader can evaluate advantages...... and disadvantages of these treatment modalities. Surgery is rarely used, except for patients who have a large goiter or ophthalmopathy. Fewer than 50% of patients treated with ATD remain in long-term remission. Therefore, radioactive iodine is used increasingly. No data as yet support the routine use of biologic...

  7. Evidence-based emergency medicine. Creating a system to facilitate translation of evidence into standardized clinical practice: a preliminary report.

    Science.gov (United States)

    Wright, Stewart W; Trott, Alexander; Lindsell, Christopher J; Smith, Carol; Gibler, W Brian

    2008-01-01

    The Institute of Medicine, through its landmark report concerning errors in medicine, suggests that standardization of practice through systematic development and implementation of evidence-based clinical pathways is an effective way of reducing errors in emergency systems. The specialty of emergency medicine is well positioned to develop a complete system of innovative quality improvement, incorporating best practice guidelines with performance measures and practitioner feedback mechanisms to reduce errors and therefore improve quality of care. This article reviews the construction, ongoing development, and initial impact of such a system at a large, urban, university teaching hospital and at 2 affiliated community hospitals. The Committee for Procedural Quality and Evidence-Based Practice was formed within the Department of Emergency Medicine to establish evidence-based guidelines for nursing and provider care. The committee measures the effect of such guidelines, along with other quality measures, through pre- and postguideline patient care medical record audits. These measures are fed back to the providers in a provider-specific, peer-matched "scorecard." The Committee for Procedural Quality and Evidence-Based Practice affects practice and performance within our department. Multiple physician and nursing guidelines have been developed and put into use. Using asthma as an example, time to first nebulizer treatment and time to disposition from the emergency department decreased. Initial therapeutic agent changed and documentation improved. A comprehensive, guideline-driven, evidence-based approach to clinical practice is feasible within the structure of a department of emergency medicine. High-level departmental support with dedicated personnel is necessary for the success of such a system. Internet site development (available at http://www.CPQE.com) for product storage has proven valuable. Patient care has been improved in several ways; however, consistent and

  8. Efficient Market Hypothesis: Some Evidences from Emerging European Forex Markets

    Directory of Open Access Journals (Sweden)

    Anoop S Kumar

    2014-06-01

    Full Text Available This study attempts to analyze the presence of weak form efficiency in the forex markets of a set of select European emerging markets namely Bulgaria, Croatia, Czech Republic, Hungary Poland, Romania, Russia, Slovakia and Slovenia using the monthly NEER data ranging from jan-1994 to Dec-2013. We employ a two step comprehensive methodology where in the first place we test for weak form efficiency using a family of individual and joint variance ratio tests. The results show that while the markets of Croatia, Czech Republic and Bulgaria may be weak form efficient at a shorter lag, the other six markets are not informationally efficient. In the next stage, we estimate a measure of relative efficiency to show the extent to which a market is weak-form inefficient. From the results, it is found that the forex markets of Croatia, Czech Republic and Bulgaria are least weak form inefficient compared to others. The findings of the study are of relevance as it shows that even after roughly two decades of free market economic policies, majority of the forex markets in the area remains informationally inefficient.

  9. Enhanced Recovery After Surgery (ERAS) - The Evidence in Geriatric Emergency Surgery

    DEFF Research Database (Denmark)

    Paduraru, Mihai; Ponchietti, Luca; Casas, Isidro Martinez

    2017-01-01

    Background: Geriatric surgery is rising and projected to continue at a greater rate. There is already concern about the poor outcomes for the emergency surgery in elderly. How to manage the available resources to improve outcomes in this group of patients is an important object of debate...... to conventional care. Emergency surgical patients also had fewer postoperative complications with ERAS compared to conventional care. Hospital stay was reduced in 2 out of 3 studies for emergency surgery.Conclusions:ERAS can be safely applied to elderly and emergency patients with a reduction in postoperative....... OBJECTIVES: We aimed to determine the feasibility and safety of applying ERAS pathways to emergency elderly surgical patients. METHOD: Two searches were undertaken for ERAS protocols in elderly patients and emergency surgery, in order to gather evidence in relation to ERAS in geriatric emergency patients...

  10. Evidence Aid: Using Systematic Reviews to Improve Access to Evidence for Humanitarian Emergencies

    Directory of Open Access Journals (Sweden)

    Mike Clarke

    2017-10-01

    Full Text Available Evidence Aid is an international initiative to improve access to reliable evidence that will help people and organisations make well-informed decisions about interventions, actions and strategies in the disaster setting. It focuses on systematic reviews as the most reliable source of research evidence, maximising the power of existing research, avoiding undue emphasis on single studies and reducing the waste associated with research that is ignored or not accessible to decision makers. Evidence Aid is knowledge champion for influencers of the humanitarian sector, including funders, policy makers, NGOs, and humanitarian professionals. Evidence Aid was established by members of the Cochrane Collaboration after the Indian Ocean tsunami of December 2004. It provides access to information relevant to disaster risk reduction, planning, response, recovery, resilience and rehabilitation. This presentation will discuss the need for Evidence Aid, and describes its activities.Find out more about Mike.

  11. Manejo da asma aguda em adultos na sala de emergência: evidências atuais Management of acute asthma in adults in the emergency room: current evidence

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Roth Dalcin

    2009-01-01

    Full Text Available Asma é uma doença com uma alta prevalência em nosso meio e ao redor do mundo. Embora novas opções terapêuticas tenham sido recentemente desenvolvidas, parece haver um aumento mundial na sua morbidade e mortalidade. Em muitas instituições, as exacerbações asmáticas ainda se constituem em uma emergência médica muito comum. As evidências têm demonstrado que o manejo da asma aguda na sala de emergência concentra decisões cruciais que podem determinar o desfecho desta situação clínica. Nesta revisão, enfocaremos a avaliação e o tratamento do paciente com asma aguda na sala de emergência, descrevendo uma estratégia apropriada para o seu manejo. Serão consideradas as seguintes etapas: diagnóstico, avaliação da gravidade, tratamento, avaliação das complicações, decisão sobre onde se realizará o tratamento adicional e orientações por ocasião da alta da emergência. Espera-se que estas recomendações contribuam para que o médico clínico tome as decisões apropriadas durante o manejo da asma aguda na sala de emergência.Asthma is a disease with high prevalence in our country and worldwide. Although new therapeutic approaches have been developed recently, there seems to be a global increase in morbidity and mortality from asthma. In many institutions, asthma exacerbation is still a common medical emergency. Clinical evidence demonstrates that management of acute asthma in the emergency room entails crucial decisions that could determine the clinical outcome. In this review, the authors focus on assessment and treatment of patients with acute asthma and outline an appropriate management strategy. Diagnosis, severity assessment, treatment, complications, decision about where additional treatment will take place and orientations on discharge from the emergency will be considered. It is expected that these recommendations will help physicians to make the appropriate decisions about care of acute asthma in the emergency

  12. Inclusion understood from the perspectives of children with disability.

    Science.gov (United States)

    Spencer-Cavaliere, Nancy; Watkinson, E Jane

    2010-10-01

    This study explored the perspectives of children with disabilities regarding the concept of inclusion in physical activity. Participants were children (two girls, nine boys, Mage = 10 years, five months, age range: 8-12 years) with disabilities, including cerebral palsy, fine and gross motor delays, developmental coordination disorder, muscular dystrophy, nemaline myopathy, brachial plexus injury, and severe asthma. Children's perspectives on inclusion in physical activity (e.g., sports, games, and play) were explored through semistructured interviews. Interviews were digitally audio taped and transcribed verbatim. Data were analyzed through content analysis. Three themes emerged from the data: gaining entry to play, feeling like a legitimate participant, and having friends. These themes were associated with feeling included to varying degrees in sports, games, and play. In essence, it was the actions of others that were the prominent features identified by children that contributed to feeling more or less included in physical activity contexts. These results are discussed in relation to inclusion in physical education, recreation, and unstructured free play.

  13. Clinical governance; How been understood, what is needed? Nurses' perspective

    Directory of Open Access Journals (Sweden)

    Homayoun Sadeghi Bazargani

    2015-07-01

    Full Text Available Introduction: Clinical Governance (CG is an overarching concept, using organizational capacity, safeguards high standards of the health services and provides a safe care for patients.  The aim of this research was to study nurses’ perception about Clinical Governance. Materials and Methods: A qualitative study was done with Focus Group Discussions (FGD. Purposeful Sampling was used to select the objectives including 65 participants. Actually 7 FGD’s were held. Content analysis was used to extract the meaningful themes. Results:Nurses believed that patient centeredness and evidence based practice is the core of the CG concept. Also they mentioned that cultural change, staffs training, adequate financial and human resources are required to successfully implementation of CG in hospitals.  Conclusion: Spreading up a shared vision about CG and providing the required infrastructures in hospitals would be facilitate CG initiatives. Proper commitment of the managers and staff participation could lead an effective CG implementation.

  14. Research into Australian emergency services personnel mental health and wellbeing: An evidence map.

    Science.gov (United States)

    Varker, Tracey; Metcalf, Olivia; Forbes, David; Chisolm, Katherine; Harvey, Sam; Van Hooff, Miranda; McFarlane, Alexander; Bryant, Richard; Phelps, Andrea J

    2018-02-01

    Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.

  15. Reflecting on Learner Assessments and Their Validity in the Presence of Emerging Evidence from Neuroscience

    Science.gov (United States)

    Watagodakumbura, Chandana

    2015-01-01

    We can now get purposefully directed in the way we assess our learners in light of the emergence of evidence from the field of neuroscience. Why higher-order learning or abstract concepts need to be the focus in assessment is elaborated using the knowledge of semantic and episodic memories. With most of our learning identified to be implicit, why…

  16. Evidence of Early Emergence of the Primary Dentition in a Northern Plains American Indian Population.

    Science.gov (United States)

    Dawson, D V; Blanchette, D R; Douglass, J M; Tinanoff, N; Kramer, K W O; Warren, J J; Phipps, K R; Starr, D E; Marshall, T A; Mabry, T R; Pagan-Rivera, K; Banas, J A; Drake, D R

    2018-04-01

    The purposes of this study were to describe primary tooth emergence in an American Indian (AI) population during the first 36 mo of life to compare 1) patterns of emergence between male and female children and 2) tooth emergence between these AI children and other U.S. ethnic groups. Data were derived from a birth cohort of 239 AI children from a Northern Plains tribe participating in a longitudinal study of early childhood caries, with examination data at target ages of 8, 12, 16, 22, 28, and 36 mo of age (±1 mo). Patterns of emergence in AI children were characterized and sex comparisons accomplished with interval-censored survival methodology. Numbers of erupted teeth in AI children at each age were compared via Kruskal-Wallis tests against those in children of the same age, as drawn from a cross-sectional study of dental caries patterns in Arizona; these comparisons were based on the dental examinations of 547 White non-Hispanic and 677 Hispanic children. Characterization of time to achievement of various milestones-including emergence of the anterior teeth, the first molars, and the complete primary dentition-provided no evidence of sex differences among AI children. AI children had significantly more teeth present at 8 mo (median, 3) than either White non-Hispanic ( P 0.05). These results provide evidence of earlier tooth emergence in AI children than in the other 2 ethnicities. Although the underlying etiology of the severity of early childhood caries in AI children is likely to be multifactorial, earlier tooth emergence may be a contributing factor. Knowledge Transfer Statement: The findings of this study have practical implications for practitioners providing childhood oral health care to ethnic groups with early tooth emergence. It may be important to provide parents with information on toothbrushing, dentist visits, and other practices supportive of good oral health as early as possible to protect their children's primary dentition.

  17. Hinkley Point 'C' power station public inquiry: proof of evidence on emergency planning

    International Nuclear Information System (INIS)

    Western, D.J.

    1988-09-01

    A public inquiry has been set up to examine the planning application made by the Central Electricity Generating Board (CEGB) for the construction of a 1200 MW Pressurized Water Reactor power station at Hinkley Point (Hinkley Point ''C'') in the United Kingdom, adjacent to an existing nuclear power station incorporating Magnox and Advanced Gas Cooled reactors. The CEGB evidence to the Inquiry presented here introduces the concept of the Reference Accident as the basis for emergency arrangements. The description which follows of the emergency arrangements at the Hinkley Point site include: the respective responsibilities and their co-ordination of bodies such as the CEGB, external emergency services and government departments; the site emergency organization; practical aspects of the emergency arrangements; and consideration of the extension of the arrangements to a PWR on the same site. Recent developments in emergency planning, such as those arising out of post Chernobyl reviews and the Sizewell ''B'' PWR Inquiry, are taken into account. The conclusion is reached that soundly based emergency arrangements already exist at Hinkley Point which would require relatively minor changes should the proposed PWR be constructed. (UK)

  18. Pediatric orthopedic injuries: evidence-based management in the emergency department [digest].

    Science.gov (United States)

    Lien, Jamie; Pade, Kathryn H

    2017-09-22

    Upper and lower extremity injuries are common in children, with an overall risk of fracture estimated at just under 1 in 5 children. Pediatric bone anatomy and physiology produce age specific injury patterns and conditions that are unique to children, which can make accurate diagnosis difficult for emergency clinicians. This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities. Evidence-based recommendations for management of pediatric fractures, including appropriate diagnostic studies and treatment, are also discussed. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  19. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

    Science.gov (United States)

    Elliott, Julian H; Turner, Tari; Clavisi, Ornella; Thomas, James; Higgins, Julian P T; Mavergames, Chris; Gruen, Russell L

    2014-02-01

    The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are high quality, up-to-date online summaries of health research, updated as new research becomes available, and enabled by improved production efficiency and adherence to the norms of scholarly communication. Together with innovations in primary research reporting and the creation and use of evidence in health systems, living systematic review contributes to an emerging evidence ecosystem.

  20. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

    Directory of Open Access Journals (Sweden)

    Julian H Elliott

    2014-02-01

    Full Text Available The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are high quality, up-to-date online summaries of health research, updated as new research becomes available, and enabled by improved production efficiency and adherence to the norms of scholarly communication. Together with innovations in primary research reporting and the creation and use of evidence in health systems, living systematic review contributes to an emerging evidence ecosystem.

  1. Targeting carbonic anhydrase to treat diabetic retinopathy: Emerging evidences and encouraging results

    Energy Technology Data Exchange (ETDEWEB)

    Weiwei, Zhang [Department of Endocrinology and Metabolism, HuaShan Hospital, Institute of Endocrinology and Diabetology, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Road, Shanghai 200040 (China); Hu, Renming, E-mail: taylorzww@gmail.com [Department of Endocrinology and Metabolism, HuaShan Hospital, Institute of Endocrinology and Diabetology, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Road, Shanghai 200040 (China)

    2009-12-18

    Diabetic retinopathy (DR) is the leading cause of vision loss among working-age populations in developed countries. Current treatment options are limited to tight glycemic, blood pressure control and destructive laser surgery. Carbonic anhydrases (CAs) are a group of enzymes involving in the rapid conversion of carbon dioxide to bicarbonate and protons. Emerging evidences reveal CA inhibitors hold the promise for the treatment of DR. This article summarizes encouraging results from clinical and animal studies, and reviews the possible mechanisms.

  2. Targeting carbonic anhydrase to treat diabetic retinopathy: Emerging evidences and encouraging results

    International Nuclear Information System (INIS)

    Weiwei, Zhang; Hu, Renming

    2009-01-01

    Diabetic retinopathy (DR) is the leading cause of vision loss among working-age populations in developed countries. Current treatment options are limited to tight glycemic, blood pressure control and destructive laser surgery. Carbonic anhydrases (CAs) are a group of enzymes involving in the rapid conversion of carbon dioxide to bicarbonate and protons. Emerging evidences reveal CA inhibitors hold the promise for the treatment of DR. This article summarizes encouraging results from clinical and animal studies, and reviews the possible mechanisms.

  3. Preferential Cyclooxygenase 2 Inhibitors as a Nonhormonal Method of Emergency Contraception: A Look at the Evidence.

    Science.gov (United States)

    Weiss, Erich A; Gandhi, Mona

    2016-04-01

    To review the literature surrounding the use of preferential cyclooxygenase 2 (COX-2) inhibitors as an alternative form of emergency contraception. MEDLINE (1950 to February 2014) was searched using the key words cyclooxygenase or COX-2 combined with contraception, emergency contraception, or ovulation. Results were limited to randomized control trials, controlled clinical trials, and clinical trials. Human trials that measured the effects of COX inhibition on female reproductive potential were included for review. The effects of the COX-2 inhibitors rofecoxib, celecoxib, and meloxicam were evaluated in 6 trials. Each of which was small in scope, enrolled women of variable fertility status, used different dosing regimens, included multiple end points, and had variable results. Insufficient evidence exists to fully support the use of preferential COX-2 inhibitors as a form of emergency contraception. Although all trials resulted in a decrease in ovulatory cycles, outcomes varied between dosing strategies and agents used. A lack of homogeneity in these studies makes comparisons difficult. However, success of meloxicam in multiple trials warrants further study. Larger human trials are necessary before the clinical utility of this method of emergency contraception can be fully appreciated. © The Author(s) 2014.

  4. Evidence-based management of potassium disorders in the emergency department [digest].

    Science.gov (United States)

    Ashurst, John; Sergent, Shane R; Wagner, Benjamin J; Kim, Jeremy

    2016-11-22

    Hypokalemia and hyperkalemia are the most common electrolyte disorders managed in the emergency department. The diagnosis of these potentially life-threatening disorders is challenging due to the often vague symptomatology a patient may express, and treatment options may be based upon very little data due to the time it may take for laboratory values to return. This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders. In this review, classic paradigms, such as the use of sodium polystyrene and the routine measurement of serum magnesium, are tested, and an algorithm for the treatment of potassium disorders is discussed. [Points & Pearls is a digest of Emergency Medicine Practice].

  5. Diphtheria, pertussis, and tetanus: evidence-based management of pediatric patients in the emergency department [digest].

    Science.gov (United States)

    Zibners, Lara; Chaudhari, Pradip

    2017-02-22

    Diphtheria, pertussis, and tetanus are potentially deadly bacterial infections that are largely preventable through vaccination, though they remain in the population. This issue reviews the epidemiology, pathophysiology, diagnosis, and current recommended emergency management of these conditions. Disease-specific medications, as well as treatment of the secondary complications, are examined in light of the best current evidence. Resources include obtaining diphtheria antitoxin from the United States Centers for Disease Control and Prevention and best-practice recommendations with regard to testing, involvement of government health agencies, isolation of the patient, and identification and treatment of close contacts. Most importantly, issues regarding vaccination and prevention are highlighted. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  6. Evidence of an emerging digital divide among hospitals that care for the poor.

    Science.gov (United States)

    Jha, Ashish K; DesRoches, Catherine M; Shields, Alexandra E; Miralles, Paola D; Zheng, Jie; Rosenbaum, Sara; Campbell, Eric G

    2009-01-01

    Some hospitals that disproportionately care for poor patients are falling behind in adopting electronic health records (EHRs). Data from a national survey indicate early evidence of an emerging digital divide: U.S. hospitals that provide care to large numbers of poor patients also had minimal use of EHRs. These same hospitals lagged others in quality performance as well, but those with EHR systems seemed to have eliminated the quality gap. These findings suggest that adopting EHRs should be a major policy goal of health reform measures targeting hospitals that serve large populations of poor patients.

  7. Diphtheria, pertussis, and tetanus: evidence-based management of pediatric patients in the emergency department

    Science.gov (United States)

    Zibners, Lara

    2017-02-01

    Diphtheria, pertussis, and tetanus are potentially deadly bacterial infections that are largely preventable through vaccination, though they remain in the population. This issue reviews the epidemiology, pathophysiology, diagnosis, and current recommended emergency management of these conditions. Disease-specific medications, as well as treatment of the secondary complications, are examined in light of the best current evidence. Resources include obtaining diphtheria antitoxin from the United States Centers for Disease Control and Prevention and best-practice recommendations with regard to testing, involvement of government health agencies, isolation of the patient, and identification and treatment of close contacts. Most importantly, issues regarding vaccination and prevention are highlighted.

  8. Inappropriate emergency laboratory test ordering: defensive or peer evidence shared based medicine?

    Directory of Open Access Journals (Sweden)

    C. Descovich

    2013-05-01

    Full Text Available BACKGROUND The laboratory overuse is widely prevalent in hospital practice, mostly in the emergency care. Reasons for excessive and inappropriate test-ordering include defensive behaviour and fear or uncertainty, lack of experience, the misuse of protocols and guidelines, “routine” and local attitudes, inadequate educational feedback and clinician’s unawareness about the cost of examinations and their related implications. AIM OF THE STUDY AND METHODS The primary target of our working group was to reduce inappropriate ordering on a urgent basis test, implementing further examinations not yet previewed in the hospital panel of the available urgencies, according to the evidence based diagnosis concept. The secondary goal was to indicate strategies of re-engineering of the processes, improving turnaround time in the laboratory management of emergencies. After evaluating, as first intervention, the more reliable sources for practice guidelines, systematic reviews and RCTs, the committee further discussed main topics with in-hospital stakeholders, selected from Emergency, Internal Medicine and Surgery Depts. The working group, in many subsequent audits, tried to obtain a systematic feed back with all involved professionals. RESULTS After reviewing literature’s evidence, the board constrained testing options by defining the basic emergency laboratory panel tests (blood type, hemogram, blood urea nitrogen, plasma creatinine, glucose, sodium, potassium, chloride, osmolarity, CRP, bicarbonate, CPK, creatine phosphokinase-MB, myoglobin, troponin, BNP and NT-proBNP, PT-INR, PTT, D-dimer, beta- HCG, biochemical urinalysis etc.. As final result, the proposed tests reduced the overall number of inappropriate investigations and increased, with newer and updated tests, the available panel for critical patients. DISCUSSION A collegiate review of data reporting, in-hospital deepening of problems and the inter- professional discussion of the evidences

  9. Stock returns predictability and the adaptive market hypothesis in emerging markets: evidence from India.

    Science.gov (United States)

    Hiremath, Gourishankar S; Kumari, Jyoti

    2014-01-01

    This study addresses the question of whether the adaptive market hypothesis provides a better description of the behaviour of emerging stock market like India. We employed linear and nonlinear methods to evaluate the hypothesis empirically. The linear tests show a cyclical pattern in linear dependence suggesting that the Indian stock market switched between periods of efficiency and inefficiency. In contrast, the results from nonlinear tests reveal a strong evidence of nonlinearity in returns throughout the sample period with a sign of tapering magnitude of nonlinear dependence in the recent period. The findings suggest that Indian stock market is moving towards efficiency. The results provide additional insights on association between financial crises, foreign portfolio investments and inefficiency. G14; G12; C12.

  10. Evidence-based review and appraisal of the use of droperidol in the emergency department

    Directory of Open Access Journals (Sweden)

    Pei-Chun Lai

    2018-01-01

    Full Text Available Droperidol is a short-acting, potent dopamine D2 antagonist that can pass through the blood–brain barrier. A black box warning was issued for droperidol by the United States Food and Drug Administration in 2001 because of a risk of development of torsades de pointes induced by QT prolongation. Many experts feel that the incidence of arrhythmia is overestimated, and low-dose droperidol is almost always used by anesthesiologists for postoperative nausea and vomiting. In this review, we used evidence-based analysis to appraise high-quality studies with a low risk of bias published after 2001 on the use of droperidol in the emergency department (ED. Droperidol appears not only efficacious but also safe to treat patients with nausea/vomiting, acute psychosis, and migraine in the ED. For these conditions, droperidol may be an option for shared decision-making.

  11. Deficits in postural control in individuals with COPD - emerging evidence for an important secondary impairment

    Directory of Open Access Journals (Sweden)

    Beauchamp Maria K

    2010-12-01

    Full Text Available Abstract Emerging evidence suggests that individuals with COPD demonstrate reductions in balance control that may be associated with an increased fall risk. The purpose of this review is to: 1 provide a brief overview of balance control and its assessment; 2 review relevant literature describing balance impairment in individuals with COPD; and 3 highlight important areas for future research. The observation of balance deficits and an increased fall risk in patients with COPD suggests the need for including balance assessment and training for patients enrolled in pulmonary rehabilitation who may be vulnerable. Further studies are needed to determine which aspects of balance are affected and to examine the impact of interventions.

  12. Addressing overuse in emergency medicine: evidence of a role for greater patient engagement.

    Science.gov (United States)

    Newton, Erika H

    2017-12-01

    Overuse of health care refers to tests, treatments, and even health care settings when used in circumstances where they are unlikely to help. Overuse is not only wasteful, it threatens patient safety by exposing patients to a greater chance of harm than benefit. It is a widespread problem and has proved resistant to change. Overuse of diagnostic testing is a particular problem in emergency medicine. Emergency physicians cite fear of missing a diagnosis, fear of law suits, and perceived patient expectations as key contributors. However, physicians' assumptions about what patients expect are often wrong, and overlook two of patients' most consistently voiced priorities: communication and empathy. Evidence indicates that patients who are more fully informed and engaged in their care often opt for less aggressive approaches. Shared decision making refers to (1) providing balanced information so that patients understand their options and the trade-offs involved, (2) encouraging them to voice their preferences and values, and (3) engaging them-to the extent appropriate or desired-in decision making. By adopting this approach to discretionary decision making, physicians are better positioned to address patients' concerns without the use of tests and treatments patients neither need nor value.

  13. 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

  14. An Evidence Framework for Off-Patent Pharmaceutical Review (EFOR) for Health Technology Assessment in Emerging Markets.

    Science.gov (United States)

    Brixner, Diana; Kaló, Zoltán; Maniadakis, Nikos; Kim, Kyoo; Wijaya, Kalman

    2018-03-29

    This article introduces an Evidence Framework for Off-Patent Pharmaceutical Review (EFOR), which establishes value-based criteria in a template that manufacturers use to provide evidence showing how their products meet those criteria. Health authorities in emerging markets can then use the evidence presented in the EFOR to evaluate off-patent pharmaceuticals (OPPs) in a consistent, transparent, and evidence-based manner to support policy decisions, including pricing, reimbursement, formulary listing, and drug procurement. A literature search found no multi-criteria evidence framework for evaluating OPPs in emerging markets. An International Outcomes Research Board (IORB) of academia and industry experts conducted extensive research, meetings, and workshops to define high-priority criteria to incorporate into an evidence-based health technology assessment (HTA) tool using the multi-criteria decision analysis (MCDA) technique. The resulting framework was further tailored for country-specific needs in workshops in three emerging countries (Kazakhstan, Vietnam, and Indonesia). The IORB defined nine criteria four categories (Product, Manufacturing, Service, and Value Assessment), which OPP manufacturers can use to provide evidence for reimbursement and health policy decision making. Then the IORB developed the EFOR as a base case document, which can be adapted and used as a template by health authorities in emerging countries. Emerging countries have a significant need for an HTA tool that balances affordability with accurate evidence showing the value differentiation of OPPs. The value attributes in this setting often are different from those in developed markets, which emphasize new products and have high regulation and manufacturing standards. The EFOR is an easy-to-use, adaptable framework that emerging countries can use to increase the consistency, transparency, and effectiveness of drug decision making. The open source EFOR is available as Supplemental Materials

  15. Adaptive thermogenesis by dietary n-3 polyunsaturated fatty acids: Emerging evidence and mechanisms.

    Science.gov (United States)

    Fan, Rong; Koehler, Karsten; Chung, Soonkyu

    2018-04-19

    Brown/beige fat plays a crucial role in maintaining energy homeostasis through non-shivering thermogenesis in response to cold temperature and excess nutrition (adaptive thermogenesis). Although numerous molecular and genetic regulators have been identified, relatively little information is available regarding thermogenic dietary molecules. Recently, a growing body of evidence suggests that high consumption of n-3 polyunsaturated fatty acids (PUFA) or activation of GPR120, a membrane receptor of n-3 PUFA, stimulate adaptive thermogenesis. In this review, we summarize the emerging evidence that n-3 PUFA promote brown/beige fat formation and highlight the potential mechanisms whereby n-3 PUFA require GPR120 as a signaling platform or act independently. Human clinical trials are revisited in the context of energy expenditure. Additionally, we explore some future perspective that n-3 PUFA intake might be a useful strategy to boost or sustain metabolic activities of brown/beige fat at different lifecycle stages of pregnancy and senescence. Given that a high ratio of n-6/n-3 PUFA intake is associated with the development of obesity and type 2 diabetes, understanding the impact of n-6/n-3 ratio on energy expenditure and adaptive thermogenesis will inform the implementation of a novel nutritional strategy for preventing obesity. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Law and Politics, an Emerging Epidemic: A Call for Evidence-Based Public Health Law.

    Science.gov (United States)

    Ulrich, Michael R

    2016-05-01

    As Jacobson v. Massachusetts recognized in 1905, the basis of public health law, and its ability to limit constitutional rights, is the use of scientific data and empirical evidence. Far too often, this important fact is lost. Fear, misinformation, and politics frequently take center stage and drive the implementation of public health law. In the recent Ebola scare, political leaders passed unnecessary and unconstitutional quarantine measures that defied scientific understanding of the disease and caused many to have their rights needlessly constrained. Looking at HIV criminalization and exemptions to childhood vaccine requirements, it becomes clear that the blame cannot be placed on the hysteria that accompanies emergencies. Indeed, these examples merely illustrate an unfortunate array of examples where empirical evidence is ignored in the hopes of quelling paranoia. These policy approaches are not only constitutionally questionable, they generate their own risk to public health. The ability of the law to jeopardize public health approaches to infectious disease control can, and should, be limited through a renewed emphasis on science as the foundation of public health, coordination through all levels and branches of government, and through a serious commitment by the judiciary to provide oversight. Infectious disease creates public anxiety, but this cannot justify unwarranted dogmatic approaches as a response. If we as a society hope to ensure efficient, constitutional control over the spread of disease, it is imperative that science take its rightful place at the forefront of governmental decision-making and judicial review. Otherwise, the law becomes its own public health threat.

  17. Validity Evidence for a Serious Game to Assess Performance on Critical Pediatric Emergency Medicine Scenarios.

    Science.gov (United States)

    Gerard, James M; Scalzo, Anthony J; Borgman, Matthew A; Watson, Christopher M; Byrnes, Chelsie E; Chang, Todd P; Auerbach, Marc; Kessler, David O; Feldman, Brian L; Payne, Brian S; Nibras, Sohail; Chokshi, Riti K; Lopreiato, Joseph O

    2018-01-26

    We developed a first-person serious game, PediatricSim, to teach and assess performances on seven critical pediatric scenarios (anaphylaxis, bronchiolitis, diabetic ketoacidosis, respiratory failure, seizure, septic shock, and supraventricular tachycardia). In the game, players are placed in the role of a code leader and direct patient management by selecting from various assessment and treatment options. The objective of this study was to obtain supportive validity evidence for the PediatricSim game scores. Game content was developed by 11 subject matter experts and followed the American Heart Association's 2011 Pediatric Advanced Life Support Provider Manual and other authoritative references. Sixty subjects with three different levels of experience were enrolled to play the game. Before game play, subjects completed a 40-item written pretest of knowledge. Game scores were compared between subject groups using scoring rubrics developed for the scenarios. Validity evidence was established and interpreted according to Messick's framework. Content validity was supported by a game development process that involved expert experience, focused literature review, and pilot testing. Subjects rated the game favorably for engagement, realism, and educational value. Interrater agreement on game scoring was excellent (intraclass correlation coefficient = 0.91, 95% confidence interval = 0.89-0.9). Game scores were higher for attendings followed by residents then medical students (Pc game and written test scores (r = 0.84, P game scores to assess knowledge of pediatric emergency medicine resuscitation.

  18. Emergence Corporate Financial Distressin Emerging Market: Empirical Evidence from Indonesia Stock Exchange(IDX 2004-2008

    Directory of Open Access Journals (Sweden)

    Koes Pranowo

    2011-11-01

    Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 st1\\:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Financial recovery is the most difficult in financial management. Therefore, this is important to study how a company in financially-distress can survive to rise up to a healthy financial condition (emergence financial distress. The research consists of 200 non financial companies which are listed on Indonesia Stock Exchange (IDX for the period of 2004-2008. This study focuses on management of working capital. How a company fulfill its current liabilities, and its sources in current assets which shall be cashed at the short term period. By using Multinomial logit, we analyzed the probability a financially-distress company rise up to emergence financial distress or stay of the status of financial distress and what are financial indicators affect to a company in the status of Non Financial Distress tend to Financial Distress. Thus, the important thing is to determine financial ratios which can be an indicator to determine of emergence financial distress. We find a positive relationship between Profit, efficiency and emergence financial distress and a negative relationship between leverage and emergence financial distress.   Keywords: Emergence Financial Distress, Indonesia Stock Exchange (IDX, Multinomial Logit JEL Classification Codes: G 3

  19. Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Michael W. Manning

    2017-12-01

    Full Text Available Introduction The Association of American Medical Colleges’ (AAMC initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to “identify system failures and contribute to a culture of safety and improvement.” We set out to determine the feasibility of using medical students’ action learning projects (ALPs to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism. Methods These prospective quality improvement (QI initiatives were performed over six months in three Northeastern PA hospitals. Emergency physician mentors were recruited to facilitate a QI experience for third-year medical students for each project. Six students were assigned to each mentor and given class time and network infrastructure support (information technology, consultant experts in lean management to work on their projects. Students had access to background network data that revealed potential for improvement in disposition (home for patients. Results Under the leadership of their mentors, students accomplished standard QI processes such as performing the background literature search and assessing key stakeholders’ positions that were involved in the respective patient’s care. Students effectively developed flow diagrams, computer aids for clinicians and educational programs, and participated in recruiting champions for the new practice standard. They met with other departmental clinicians to determine barriers to implementation and used this feedback to help set specific parameters to make clinicians more comfortable with the changes in practice that were recommended. All three clinical practice guidelines were initiated at consummation of the students’ projects. After implementation, 86% (38/44 of queried ED providers felt comfortable

  20. Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department.

    Science.gov (United States)

    Manning, Michael W; Bean, Eric W; Miller, Andrew C; Templer, Suzanne J; Mackenzie, Richard S; Richardson, David M; Bresnan, Kristin A; Greenberg, Marna R

    2018-01-01

    The Association of American Medical Colleges' (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to "identify system failures and contribute to a culture of safety and improvement." We set out to determine the feasibility of using medical students' action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism). These prospective quality improvement (QI) initiatives were performed over six months in three Northeastern PA hospitals. Emergency physician mentors were recruited to facilitate a QI experience for third-year medical students for each project. Six students were assigned to each mentor and given class time and network infrastructure support (information technology, consultant experts in lean management) to work on their projects. Students had access to background network data that revealed potential for improvement in disposition (home) for patients. Under the leadership of their mentors, students accomplished standard QI processes such as performing the background literature search and assessing key stakeholders' positions that were involved in the respective patient's care. Students effectively developed flow diagrams, computer aids for clinicians and educational programs, and participated in recruiting champions for the new practice standard. They met with other departmental clinicians to determine barriers to implementation and used this feedback to help set specific parameters to make clinicians more comfortable with the changes in practice that were recommended. All three clinical practice guidelines were initiated at consummation of the students' projects. After implementation, 86% (38/44) of queried ED providers felt comfortable with medical students being a part of future ED QI

  1. Emerging Evidence for MicroRNAs as Regulators of Cancer Stem Cells

    Energy Technology Data Exchange (ETDEWEB)

    Sethi, Aisha [Department of Pathology, Henry Ford Hospital, Detroit, MI 48202 (United States); Sholl, Lynette M., E-mail: lmsholl@partners.org [Department of Pathology, Brigham and Women' s Hospital and Harvard Medical School, Boston, MA 02115 (United States)

    2011-10-24

    Cancer stem cells are defined as a subpopulation of cells within a tumor that are capable of self-renewal and differentiation into the heterogeneous cell lineages that comprise the tumor. Many studies indicate that cancer stem cells may be responsible for treatment failure and relapse in cancer patients. The factors that regulate cancer stem cells are not well defined. MicroRNAs (miRNAs) are small non-coding RNAs that regulate translational repression and transcript degradation. miRNAs play a critical role in embryonic and inducible pluripotent stem cell regulation and emerging evidence supports their role in cancer stem cell evolution. To date, miRNAs have been shown to act either as tumor suppressor genes or oncogenes in driving critical gene expression pathways in cancer stem cells in a wide range of human malignancies, including hematopoietic and epithelial tumors and sarcomas. miRNAs involved in cancer stem cell regulation provide attractive, novel therapeutic targets for cancer treatment. This review attempts to summarize progress to date in defining the role of miRNAs in cancer stem cells.

  2. Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services.

    Science.gov (United States)

    Fowler, Patrick J; Farrell, Anne F; Marcal, Katherine E; Chung, Saras; Hovmand, Peter S

    2017-09-01

    Inadequate housing threatens family stability in communities across the United States. This study reviews emerging evidence on housing interventions in the context of scale-up for the child welfare system. In child welfare, scale-up refers to the extent to which fully implemented interventions sustainably alleviate family separations associated with housing instability. It incorporates multiple aspects beyond traditional measures of effectiveness including costs, potential reach, local capacities for implementation, and fit within broader social services. The framework further encompasses everyday circumstances faced by service providers, program administrators, and policymakers who allocate resources under conditions of scarcity and uncertainty. The review of current housing interventions reveals a number of systemic constraints for scale-up in child welfare. Reliance on rental assistance programs limits capacity to address demand, while current practices that target the most vulnerable families may inadvertently diminish effectiveness of the intervention and increase overall demand. Alternative approaches that focus on homelessness prevention and early intervention must be tested in conjunction with community initiatives to increase accessibility of affordable housing. By examining system performance over time, the scalability framework provides an opportunity for more efficient coordination of housing services within and outside of the child welfare system. © Society for Community Research and Action 2017.

  3. Strategic human resource management and corporate social responsibility: Evidence from Emerging Markets

    Directory of Open Access Journals (Sweden)

    Talita Rosolen

    2016-09-01

    Full Text Available Corporate social responsibility practices are increasingly being adopted and legitimized in business and they impact the strategic and operational levels in various areas. The integration of these criteria and practices in the strategic management involves many factors, and human resource management is an essential aspect for the accomplishment of such initiative. Thus, this paper associates the relationship among corporate social responsibility (CSR various dimensions (strategic, ethical, social and environmental and strategic human resource management (SHRM in companies operating in Brazil. We also aim to identify whether there is impact of other aspects on this relationship, namely: size, industry and company internationalization level (if national or multinational. Results show evidence that ethical CSR can be associated to SHRM. Environmental CSR showed marginal relation, and social and strategic CSR presented no significant association. Those results emphasize the need to further develop strategic actions of CSR into human resource management in emerging markets. Managers can also benefit from those findings, as it is possible to have a broad view of limitations and opportunities regarding the role played by human resource management in CSR.

  4. Emerging Evidence for MicroRNAs as Regulators of Cancer Stem Cells

    International Nuclear Information System (INIS)

    Sethi, Aisha; Sholl, Lynette M.

    2011-01-01

    Cancer stem cells are defined as a subpopulation of cells within a tumor that are capable of self-renewal and differentiation into the heterogeneous cell lineages that comprise the tumor. Many studies indicate that cancer stem cells may be responsible for treatment failure and relapse in cancer patients. The factors that regulate cancer stem cells are not well defined. MicroRNAs (miRNAs) are small non-coding RNAs that regulate translational repression and transcript degradation. miRNAs play a critical role in embryonic and inducible pluripotent stem cell regulation and emerging evidence supports their role in cancer stem cell evolution. To date, miRNAs have been shown to act either as tumor suppressor genes or oncogenes in driving critical gene expression pathways in cancer stem cells in a wide range of human malignancies, including hematopoietic and epithelial tumors and sarcomas. miRNAs involved in cancer stem cell regulation provide attractive, novel therapeutic targets for cancer treatment. This review attempts to summarize progress to date in defining the role of miRNAs in cancer stem cells

  5. Zika Virus-associated Ocular and Neurologic Disorders: The Emergence of New Evidence.

    Science.gov (United States)

    Şahiner, Fatih; Siğ, Ali Korhan; Savaşçi, Ümit; Tekin, Kemal; Akay, Fahrettin

    2017-12-01

    It has been approximately 70 years since the discovery of the Zika virus (ZIKV). It had been established that the virus causes mild infections and is confined to Africa and Asia; however, major changes in the clinical and epidemiologic patterns of ZIKV infection have occurred in recent years. The virus has attracted intense interest because of the possible association of several autoimmune and neurodevelopmental disorders. We present a summary of the articles that attempt to explain the ZIKV unknowns and strengthen the association with some disorders that are thought to be related to ZIKV, by describing the discovery milestones from the initial identification of the virus to the present day. New evidence strengthens the association between ZIKV infections and Guillain-Barré syndrome (GBS), microcephaly and various neurodevelopmental and ophthalmologic disorders as a result of numerous new clinical and experimental studies. The World Health Organization declared the end of the "Public Health Emergency of International Concern" in December 2016, but ZIKV and associated consequences remain a significant enduring public health challenge.

  6. Effect of the Affordable Care Act Medicaid Expansion on Emergency Department Visits: Evidence From State-Level Emergency Department Databases.

    Science.gov (United States)

    Nikpay, Sayeh; Freedman, Seth; Levy, Helen; Buchmueller, Tom

    2017-08-01

    We assess whether the expansion of Medicaid under the Patient Protection and Affordable Care Act (ACA) results in changes in emergency department (ED) visits or ED payer mix. We also test whether the size of the change in ED visits depends on the change in the size of the Medicaid population. Using all-capture, longitudinal, state data from the Agency for Healthcare Research and Quality's Fast Stats program, we implemented a difference-in-difference analysis, which compared changes in ED visits per capita and the share of ED visits by payer (Medicaid, uninsured, and private insurance) in 14 states that did and 11 states that did not expand Medicaid in 2014. Analyses controlled for state-level demographic and economic characteristics. We found that total ED use per 1,000 population increased by 2.5 visits more in Medicaid expansion states than in nonexpansion states after 2014 (95% confidence interval [CI] 1.1 to 3.9). Among the visit types that could be measured, increases in ED visits were largest for injury-related visits and for states with the largest changes in Medicaid enrollment. Compared with nonexpansion states, in expansion states the share of ED visits covered by Medicaid increased 8.8 percentage points (95% CI 5.0 to 12.6), whereas the uninsured share decreased by 5.3 percentage points (95% CI -1.7 to -8.9). The ACA's Medicaid expansion has resulted in changes in payer mix. Contrary to other studies of the ACA's effect on ED visits, our study found that the expansion also increased use of the ED, consistent with polls of emergency physicians. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  7. Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Hinkle, Janice L; Becker, Kyra J; Kim, Jong S; Choi-Kwon, Smi; Saban, Karen L; McNair, Norma; Mead, Gillian E

    2017-07-01

    At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers. © 2017 American Heart Association, Inc.

  8. The Late Ordovician Extinction: How it became the best understood of the five major extinctions.

    Science.gov (United States)

    Sheehan, P.

    2003-04-01

    The end Ordovician extinction has become arguably the best-understood major extinction event in Earth History. A plethora of workers have established the pattern of faunal change and causes of the extinction with remarkably little disagreement. The first indication of increased extinction at the end of the Ordovician was a graph of global diversity patterns by Norman Newell in 1967, although he did not recognize it as a major event. The presence of a major extinction event became clear as William Berry and Art Boucot assembled data for Silurian correlation charts in the late 1960s. The first reports of North African glaciation in the late 1960s provided a cause for the extinction and study of the event snowballed. It was no accident that recognition of the extinction began in North America, because it was there that the extinction completely overturned faunas in the epicontinental seas. Glacio-eustatic regression of shallow seaway coincided with the disappearance of endemic Laurentian faunas and replacement by a highly cosmopolitan fauna in the Silurian. Once the event was established in North America, paleontologists soon found evidence of the event around the globe. The well-documented Hirnantia Fauna was found to correspond to the glacial interval, and Pat Brenchley soon recognized that there were two pulses of extinction, at the beginning and end of the glaciation. At the same time that the faunal changes were being documented geologic studies of the glaciation provided information on the environmental changes associated with the extinction. The timing of the glacial maximum was established in Africa and by the presence of dropstones in high latitude marine rocks. The 1990s saw geochemical techniques employed that allowed examination of atmospheric CO2 and temperature changes. In many places carbonate deposition declined. Glacio-eustatic regression was obvious in many areas, and a sea-level decline in the range of 50-100 m was established. Shallow

  9. Sport and active recreation injuries in Australia: evidence from emergency department presentations

    OpenAIRE

    Finch, C.; Valuri, G.; Ozanne-Smith, J.

    1998-01-01

    OBJECTIVE: Despite the rise in specialist clinical services for the management of sports and active recreation injury, many patients attend hospital emergency departments for treatment. The purpose of this study was to describe sports injury cases presented to selected hospital emergency departments around Australia for the period 1989-1993. METHODS: Routinely collected emergency department injury presentation data from the Australian National Injury Surveillance Unit were examined. Dat...

  10. Efficient market hypothesis in emerging markets: Panel data evidence with multiple breaks and cross sectional dependence

    OpenAIRE

    Abd Halim Ahmad; Siti Nurazira Mohd Daud; W.N.W. Azman-Saini

    2010-01-01

    The purpose of this paper is to re-examine whether mean reversion property hold for 15 emerging stock markets for the period 1985 to 2006. Utilizing a panel stationarity test that is able to account for multiple structural breaks and cross sectional dependence, we find that the emerging stock markets follow a random walk process. However, further analysis on individual series show that the majority of stock prices in emerging markets are governed by a mean reverting process. This result, whic...

  11. Do emerging markets matter in the world oil pricing system? Evidence of imported crude by China and India

    International Nuclear Information System (INIS)

    Hong Li; Lin Xiaowen, Sharon

    2011-01-01

    This paper provides empirical evidence on the changing structure of world oil price system by identifying an additional driver-emerging market factor. We choose China and India as a representative of emerging markets to examine if the quantity of crude oil imported by China and India is significant in the existing oil pricing system (. Our data starts from January 2002 and ends in March 2010, which includes the oil shock of 2007-2008. We utilize cointegration and error correction model framework developed by and in the analysis. Our results indicate that demand from emerging markets has become a significant factor in the world oil pricing system since 2003. This result is significant as it lends empirical support to the widely held conjecture that the oil shock of 2007-2008 is a demand-led shock (). Our result also has significant policy implications that go beyond the oil shock. The emerging market factor is there to stay and reflects the changing power between emerging and developed economies in the world economic system as a result of decades of fast economic development in the former. It will certainly influence policy issues related to oil and beyond. - Highlights: → We test the existing oil price modelling with data from 2002-2010. → We find evidence of structural breaks in the world oil pricing model. → We find that emerging market factor is a new driver in the world oil pricing system since 2003. → The emerging market factor lends empirical support to 'consumption-led' conjecture of oil shock. → New factor reflects significant changes of oil demand landscape following shifting economic power.

  12. Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components.

    Science.gov (United States)

    Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren

    2016-09-28

    Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30-70 percentage points within 1-3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women family planning

  13. U.S. Banking Deregulation and Emerging Market Loans: Potential Links and Evidence, 1984~2005

    Directory of Open Access Journals (Sweden)

    Hyun Koo Cho

    2010-06-01

    Full Text Available How did the deregulation of U.S. bank activities affect the patterns of cross-border lending to emerging economies? Unlike bank lending from Europe or Japan, U.S. bank lending to emerging economies exhibited increasing volatility over time. Using U.S. cross-border bank exposure data, this study identifies a temporal association between important deregulation initiatives and the volatility of U.S. bank emerging market lending. This association is explained by the linkages between an important outcome of bank deregulation-earnings volatility from diversified bank activities-and the rising volatility. Together, it argues that U.S. banking deregulation had unanticipated effects of exacerbating the volatility of bank lending to emerging economies.

  14. Severe traumatic brain injury in children: an evidence-based review of emergency department management [digest].

    Science.gov (United States)

    Morrissey, Kirsten; Fairbrother, Hilary; Vazquez, Michelle N

    2016-10-22

    More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged digest of Pediatric Emergency Medicine Practice].

  15. Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services

    Science.gov (United States)

    2018-01-11

    Background: Administrators of Emergency Medical Services (EMS) operations lack guidance on how to mitigate workplace fatigue, which affects greater than half of all EMS personnel. The primary objective of the Fatigue in EMS Project was to create an e...

  16. An Emerging Theory for Evidence Based Information Literacy Instruction in School Libraries, Part 1: Building a Foundation

    Directory of Open Access Journals (Sweden)

    Carol A. Gordon

    2009-06-01

    Full Text Available Objective – Part I of this paper aims to create a framework for an emerging theory of evidence based information literacy instruction. In order to ground this framework in existing theory, a holistic perspective views inquiry as a learning process that synthesizes information searching and knowledge building. An interdisciplinary approach is taken to relate user-centric information behavior theory and constructivist learning theory that supports this synthesis. The substantive theories that emerge serve as a springboard for emerging theory. A second objective of this paper is to define evidence based information literacy instruction by assessing the suitability of performance based assessment and action research as tools of evidence based practice.Methods – An historical review of research grounded in user-centered information behavior theory and constructivist learning theory establishes a body of existing substantive theory that supports emerging theory for evidence based information literacy instruction within an information-to-knowledge approach. A focused review of the literature presents supporting research for an evidence based pedagogy that is performance assessment based, i.e., information users are immersed in real-world tasks that include formative assessments. An analysis of the meaning of action research in terms of its purpose and methodology establishes its suitability for structuring an evidence based pedagogy. Supporting research tests a training model for school librarians and educators which integrates performance based assessment, as well as action research. Results – Findings of an historical analysis of information behavior theory and constructivist teaching practices, and a literature review that explores teaching models for evidence based information literacy instruction, point to two elements of evidence based information literacy instruction: the micro level of information searching behavior and the macro level of

  17. Finance-Growth-Crisis Nexus in Asian Emerging Economies: Evidence from VECM and ARDL Assessment

    OpenAIRE

    Takashi Fukuda; Jauhari Dahalan

    2012-01-01

    This paper examines the causal relationship between financial development, economic growth and financial crisis in the five Asian emerging economies (India, Indonesia, South Korea, Malaysia and Thailand) during the period 1982 to 2007. All of these countries are known as emerging economies with well known financial crisis episodes (i.e., India's 1991 crisis and the Asian 1997 crisis). The summary indicators of financial development, financial crisis and financial repression are constructed th...

  18. Limited evidence for intranasal fentanyl in the emergency department and the prehospital setting--a systematic review

    DEFF Research Database (Denmark)

    Hansen, Morten Sejer; Dahl, Jørgen Berg

    2013-01-01

    The intranasal (IN) mode of application may be a valuable asset in non-invasive pain management. Fentanyl demonstrates pharmacokinetic and pharmacodynamic properties that are desirable in the management of acute pain, and IN fentanyl may be of value in the prehospital setting. The aim...... of this systematic review was to evaluate the current evidence for the use of IN fentanyl in the emergency department (ED) and prehospital setting....

  19. Sport and active recreation injuries in Australia: evidence from emergency department presentations

    Science.gov (United States)

    Finch, C.; Valuri, G.; Ozanne-Smith, J.

    1998-01-01

    OBJECTIVE: Despite the rise in specialist clinical services for the management of sports and active recreation injury, many patients attend hospital emergency departments for treatment. The purpose of this study was to describe sports injury cases presented to selected hospital emergency departments around Australia for the period 1989-1993. METHODS: Routinely collected emergency department injury presentation data from the Australian National Injury Surveillance Unit were examined. Data on 98,040 sports and active recreation emergency department presentations were analysed. Sports and active recreation activities were ranked according to frequency of presentation. Relative proportions of injury type and body region injured were determined. Data are presented separately for children (15 years of age). RESULTS: Among the 10 activities that most commonly led to a sports or active recreation injury presentation for all ages were cycling, Australian football, basketball, soccer, cricket, netball, and rugby. For children, injuries were also commonly associated with roller skating/blading, skateboarding, and trampolining. Hockey, martial arts, and dancing injuries were frequent in adults. Most sporting injuries occurred during organised competition or practice whereas the active recreation injuries occurred in a variety of settings. Fractures, strains, and sprains, particularly to the lower and upper extremities, were common types of injury. CONCLUSION: The rich, but nevertheless limited, information available about sports and active recreation injuries from data collected in emergency departments indicates that these activities are a common context for injury at the community level in Australia. 


 PMID:9773170

  20. Sport and active recreation injuries in Australia: evidence from emergency department presentations.

    Science.gov (United States)

    Finch, C; Valuri, G; Ozanne-Smith, J

    1998-09-01

    Despite the rise in specialist clinical services for the management of sports and active recreation injury, many patients attend hospital emergency departments for treatment. The purpose of this study was to describe sports injury cases presented to selected hospital emergency departments around Australia for the period 1989-1993. Routinely collected emergency department injury presentation data from the Australian National Injury Surveillance Unit were examined. Data on 98,040 sports and active recreation emergency department presentations were analysed. Sports and active recreation activities were ranked according to frequency of presentation. Relative proportions of injury type and body region injured were determined. Data are presented separately for children (15 years of age). Among the 10 activities that most commonly led to a sports or active recreation injury presentation for all ages were cycling, Australian football, basketball, soccer, cricket, netball, and rugby. For children, injuries were also commonly associated with roller skating/blading, skateboarding, and trampolining. Hockey, martial arts, and dancing injuries were frequent in adults. Most sporting injuries occurred during organised competition or practice whereas the active recreation injuries occurred in a variety of settings. Fractures, strains, and sprains, particularly to the lower and upper extremities, were common types of injury. The rich, but nevertheless limited, information available about sports and active recreation injuries from data collected in emergency departments indicates that these activities are a common context for injury at the community level in Australia.

  1. Altered level of consciousness: evidence-based management in the emergency department [digest].

    Science.gov (United States)

    Song, Joo Lee; Wang, Vincent J; Vazquez, Michelle N

    2017-01-22

    A child who presents to the emergency department with an altered level of consciousness can be clinically unstable and can pose a great diagnostic challenge. The emergency clinician must quickly develop a wide differential of possible etiologies in order to administer potentially life-saving medications or interventions. The history, physical examination, and appropriate diagnostic tests can aid greatly in rapidly narrowing the differential diagnosis. Once initial stabilization, workup, and first-line interventions are completed, most patients who present with unresolved or unidentified altered level of consciousness should be admitted for further evaluation and close monitoring. This issue provides a review of the etiologies of altered level of consciousness as well as guidance for the management and disposition of patients with this condition. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  2. The Impact of Ownership Structure on Firm Performance : Evidence From a Large Emerging Market

    NARCIS (Netherlands)

    Douma, S.W.; George, R.; Kabir, M.R.

    2002-01-01

    We examine how ownership structure affects the performance of firms using firm level data from a large emerging market, India.We specifically focus on a previously unexplored phenomenon, namely the differential role played by foreign institutional and foreign corporate shareholders.An examination of

  3. Institutions and international investments: Evidence from China and other emerging markets

    NARCIS (Netherlands)

    Zhang, Y.

    2011-01-01

    This thesis empirically investigates the underlying factors that explain the new global trade and investment patterns. At the baseline level, three questions on the globalization process of emerging markets are addressed. First, what is the causal linkage among institutions, external trade and

  4. The emergence of new organization designs. Evidences from self-managed team-based organizations

    NARCIS (Netherlands)

    Annosi, Maria Carmela; Giustiniano, Luca; Brunetta, Federica; Magnusson, Mats

    2017-01-01

    New organization designs emerge continuously in highly dynamic innovation context to improve readiness to change. The adoption of self-managing teams operating cross-functionally on a bulk of products, together with the reduction of vertical layers in the organization, seems to be a common strategy

  5. Exports and Innovation in Emerging Economies : Firm-Level Evidence from South-Africa

    NARCIS (Netherlands)

    Vannoorenberghe, Gonzague

    2015-01-01

    Using a new dataset on the innovation and exports of 500 South African firms, this paper asks whether exports affect rm innovation in the context of an emerging economy. We use a range of particularly attractive features of the dataset. Firms not only report whether they innovated but describe their

  6. The Impacts of State Ownership on Information Asymmetry: Evidence from an Emerging Market

    Directory of Open Access Journals (Sweden)

    Jongmoo Jay Choi

    2010-06-01

    Full Text Available This study examines the effect of corporate ownership on information asymmetry as measured by bid-ask spread in the emerging markets of China. Government ownership has significant and positive impacts on bid-ask spread during the period 1995–2000, but disappears afterward during 2001–2003. The finding that state ownership raised bid-ask spread in the early period is consistent with recent studies on emerging markets including China, which indicate that firms with higher state ownership tend to have a greater deviation between cash flow rights and control rights (eg, Wei et al., 2005. This implies that lower state ownership is associated with lower information asymmetry in the market, an economic consequence of significant economic reform and privatization regarding the market microstructure. However, with more active control transfers and emergence of private controlling shareholders, regulatory changes in ownership structure and corporate governance mechanisms, and thus an improved legal and institutional environment, the link between the government ownership and information asymmetry turns to be insignificant in the later period. These results have important implications for transparency and information disclosure policies as well as privatization in emerging markets.

  7. Differences between Girls and Boys in Emerging Language Skills: Evidence from 10 Language Communities

    Science.gov (United States)

    Eriksson, Marten; Marschik, Peter B.; Tulviste, Tiia; Almgren, Margareta; Perez Pereira, Miguel; Wehberg, Sonja; Marjanovic-Umek, Ljubica; Gayraud, Frederique; Kovacevic, Melita; Gallego, Carlos

    2012-01-01

    The present study explored gender differences in emerging language skills in 13,783 European children from 10 non-English language communities. It was based on a synthesis of published data assessed with adapted versions of the MacArthur-Bates Communicative Development Inventories (CDIs) from age 0.08 to 2.06. The results showed that girls are…

  8. Can You Multitask? Evidence and Limitations of Task Switching and Multitasking in Emergency Medicine.

    Science.gov (United States)

    Skaugset, L Melissa; Farrell, Susan; Carney, Michele; Wolff, Margaret; Santen, Sally A; Perry, Marcia; Cico, Stephen John

    2016-08-01

    Emergency physicians work in a fast-paced environment that is characterized by frequent interruptions and the expectation that they will perform multiple tasks efficiently and without error while maintaining oversight of the entire emergency department. However, there is a lack of definition and understanding of the behaviors that constitute effective task switching and multitasking, as well as how to improve these skills. This article reviews the literature on task switching and multitasking in a variety of disciplines-including cognitive science, human factors engineering, business, and medicine-to define and describe the successful performance of task switching and multitasking in emergency medicine. Multitasking, defined as the performance of two tasks simultaneously, is not possible except when behaviors become completely automatic; instead, physicians rapidly switch between small tasks. This task switching causes disruption in the primary task and may contribute to error. A framework is described to enhance the understanding and practice of these behaviors. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  9. Determinants and Dynamics of Business Aspirations : Evidence from Small-scale Entrepreneurs in an Emerging Market

    NARCIS (Netherlands)

    Dalton, Patricio; Rüschenpöhler, Julius; Zia, Bilal

    2018-01-01

    Small-scale entrepreneurs are ubiquitous in emerging market economies, yet very few graduate to become larger businesses. We ask whether such entrepreneurs even aspire to grow, and if so, on which dimensions of the business? What factors influence these aspirations, how realistic are they, and do

  10. Foreign and domestic ownership, business groups, and firm performance: evidence from a large emerging market

    NARCIS (Netherlands)

    Douma, Sytse; George, Rejie; Kabir, Mohammed Rezaul

    2006-01-01

    We adopt a multi-theoretic approach to investigate a previously unexplored phenomenon in extant literature, namely the differential impact of foreign institutional and foreign corporate shareholders on the performance of emerging market firms. We show that the previously documented positive effect

  11. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

    OpenAIRE

    Julian H Elliott; Tari Turner; Ornella Clavisi; James Thomas; Julian P T Higgins; Chris Mavergames; Russell L Gruen

    2014-01-01

    The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are ...

  12. Reverse quality management: developing evidence-based best practices in health emergency management.

    Science.gov (United States)

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

  13. Market Structure, Financial Dependence and Industrial Growth: Evidence from the Banking Industry in Emerging Asian Economies

    Science.gov (United States)

    Khan, Habib Hussain; Ahmad, Rubi Binit; Gee, Chan Sok

    2016-01-01

    In this study, we examine the role of market structure for growth in financially dependent industries from 10 emerging Asian economies over the period of 1995–2011. Our approach departs from existing studies in that we apply four alternative measures of market structure based on structural and non-structural approaches and compare their outcomes. Results indicate that higher bank concentration may slow down the growth of financially dependent industries. Bank competition on the other hand, allows financially dependent industries to grow faster. These findings are consistent across a number of sensitivity checks such as alternative measures of financial dependence, institutional factors (including property rights, quality of accounting standards and bank ownership), and endogeneity consideration. In sum, our study suggests that financially dependent industries grow more in more competitive/less concentrated banking systems. Therefore, regulatory authorities need to be careful while pursuing a consolidation policy for banking sector in emerging Asian economies. PMID:27490847

  14. Emergency management of blunt chest trauma in children: an evidence-based approach.

    Science.gov (United States)

    Pauzé, Denis R; Pauzé, Daniel K

    2013-11-01

    Pediatric trauma is commonly encountered in the emergency department, and trauma to the head, chest, and abdomen may be a source of significant morbidity and mortality. As children have unique thoracic anatomical and physiological properties, they may present with diagnostic challenges that the emergency clinician must be aware of. This review examines the effects of blunt trauma to the pediatric chest, as well as its relevant etiologies and associated mortality. Diagnostic and treatment options for commonly encountered injuries such as pulmonary contusions, rib fractures, and pneumothoraces are examined. Additionally, this review discusses rarely encountered--yet highly lethal--chest wall injuries such as blunt cardiac injuries, commotio cordis, nonaccidental trauma, and aortic injuries.

  15. ARE SMALL-FIRM CLUSTERS EMERGENT PHENOMENA? EVIDENCE FROM ZIMBABWE’S SMALL FURNITURE- MANUFACTURING FIRMS

    Directory of Open Access Journals (Sweden)

    Godfrey MUPONDA

    2014-07-01

    Full Text Available The purpose of this study was to explore the reasons behind the rapid growth and apparent dynamism of Zimbabwe’s small-firm industrial clusters. The hypothesis behind the study was that these small-firm clusters are emergent phenomena. The study analysed the capital utilisation techniques of small firms located in a large industrial cluster in order to determine the factors that lead to the collective efficiency of such firms. The study found that, in comparison with large, stock exchange-listed firms, the cluster environment enables the small firm to operate from a relatively small capital base and also to use its capital more efficiently in creating revenues and profits. The individual firm does not have to invest its capital in a large assets base as this is done by a specialised group of firms within the cluster. Thus, the cluster has the characteristics of an emergent phenomenon.

  16. Market Structure, Financial Dependence and Industrial Growth: Evidence from the Banking Industry in Emerging Asian Economies.

    Science.gov (United States)

    Khan, Habib Hussain; Ahmad, Rubi Binit; Gee, Chan Sok

    2016-01-01

    In this study, we examine the role of market structure for growth in financially dependent industries from 10 emerging Asian economies over the period of 1995-2011. Our approach departs from existing studies in that we apply four alternative measures of market structure based on structural and non-structural approaches and compare their outcomes. Results indicate that higher bank concentration may slow down the growth of financially dependent industries. Bank competition on the other hand, allows financially dependent industries to grow faster. These findings are consistent across a number of sensitivity checks such as alternative measures of financial dependence, institutional factors (including property rights, quality of accounting standards and bank ownership), and endogeneity consideration. In sum, our study suggests that financially dependent industries grow more in more competitive/less concentrated banking systems. Therefore, regulatory authorities need to be careful while pursuing a consolidation policy for banking sector in emerging Asian economies.

  17. Market Structure, Financial Dependence and Industrial Growth: Evidence from the Banking Industry in Emerging Asian Economies.

    Directory of Open Access Journals (Sweden)

    Habib Hussain Khan

    Full Text Available In this study, we examine the role of market structure for growth in financially dependent industries from 10 emerging Asian economies over the period of 1995-2011. Our approach departs from existing studies in that we apply four alternative measures of market structure based on structural and non-structural approaches and compare their outcomes. Results indicate that higher bank concentration may slow down the growth of financially dependent industries. Bank competition on the other hand, allows financially dependent industries to grow faster. These findings are consistent across a number of sensitivity checks such as alternative measures of financial dependence, institutional factors (including property rights, quality of accounting standards and bank ownership, and endogeneity consideration. In sum, our study suggests that financially dependent industries grow more in more competitive/less concentrated banking systems. Therefore, regulatory authorities need to be careful while pursuing a consolidation policy for banking sector in emerging Asian economies.

  18. IMPACT OF INFLATION ON PER CAPITA INCOME IN EMERGING ECONOMIES: EVIDENCE FROM BRICS NATIONS

    Directory of Open Access Journals (Sweden)

    Khalid Ashraf CHISTI

    2015-12-01

    Full Text Available In this paper an attempt has been made to analyse the impact of Inflation on per capita income of emerging economies. In order to achieve the objective of the study the researchers have taken five major emerging countries of the world which are the members of BRICS. For the purpose of analysis, the data of thirteen years has been taken from 1999 to 2011. After employing the regression model, the results confirm that independent variable (inflation does not statistically influence the dependent variable (Per Capita Income in three countries which are India, Brazil and South Africa. However, in the other two countries (China and Russia the findings affirm the independent variable (Inflation does statistically influence the dependent variable (Per Capita Income.Therefore, it can be concluded that a change in the inflation rate can not necessarily bring a change in the per capita income of a country.

  19. Entry Mode of Firms in an Emerging Economy: Evidence from Malaysia

    OpenAIRE

    Yasmeen, Kausar; Viswanathan, Kuperan

    2016-01-01

    The dynamics of the global competition patterns and world economy are encouraging construction firms to expand into emerging economies. Entry modes and its predictors have been the subjects of interest in international market strategic management research which is nonetheless lacking in the construction firms. This paper seeks to identify the entry modes preferred by construction firms in Malaysia, on whether they choose equity modes, non-equity modes or both modes for their international pro...

  20. Stock Price Informativeness and Idiosyncratic Return Volatility in Emerging Markets: Evidence from China

    OpenAIRE

    Karen Jingrong Lin; Khondkar Karim; Clairmont Carter

    2014-01-01

    This study attempts to address two research questions on the idiosyncratic return volatility and stock price informativeness. First, whether idiosyncratic return volatility is a valid proxy for stock price informativeness in emerging markets, and if it is, whether there exists a monotonic relationship between the idiosyncratic return volatility and stock price informativeness throughout the whole sample. We find that the idiosyncratic return volatility reflects the stock price informativeness...

  1. Why is the wage share falling in emerging economies? Industry level evidence

    OpenAIRE

    Guschanski, Alexander; Onaran, Özlem

    2017-01-01

    This article presents an econometric analysis of the wage share in seven emerging economies. We focus on the effect of globalisation, captured by participation in global value chains and financial integration, indicators of bargaining power of labour and technological change on the wage share. We use input-output tables that allow us to obtain detailed measures of global value chain participation, and sectoral data to distinguish the effect on high- and low-skilled workers and within manufact...

  2. The Value of Institutions for Financial Markets; Evidence From Emerging Markets

    OpenAIRE

    Thomas Stratmann; Bernardin Akitoby

    2009-01-01

    This paper investigates the value of political institutions for financial markets, using panel data from emerging market countries. We test the hypothesis that changes in political institutions, such as improvements in democratic rights and increased government accountability, have a direct effect on sovereign interest rate spreads. We find that financial markets value institutions over and above the economic and fiscal outcomes these institutions shape. Democracy and accountability generally...

  3. Performance Effects of Stakeholder Interaction in Emerging Economies: Evidence from Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigo Bandeira-de-Mello

    2011-07-01

    Full Text Available Firm survival in emerging economies is often related to having access to valuable resources that are in stakeholders‟ hands. However, the literature on strategy in emerging economies provides scant information on the efficiency of acquiring stakeholder resources and its effect on firm performance. We investigated the stakeholder interaction effects on performance of domestic firms competing in an emerging market (Wright, Filatotchev, Hoskisson, & Peng, 2005 from a contractual perspective (Williamson, 1985. We argue that interacting stakeholders in a contractual set yield synergistic governance structures that allow firms more efficient access to external resources. Using a sample of 267 firms in Brazil (secondary data, we explored different patterns in stakeholder contracting with community, government, top management, and employees. A three-stage analysis process was devised: cluster analysis, general linear model estimation and verification tests. Results suggest that stakeholder interaction has a positive impact on firm performance. The conjoint effect of government and community contracts was found to yield superior firm performance as they provide a basic structure for contracting with other interacting stakeholders.

  4. An Emerging Theory for Evidence Based Information Literacy Instruction in School Libraries, Part 2: Building a Culture of Inquiry

    Directory of Open Access Journals (Sweden)

    Carol A. Gordon

    2009-09-01

    Full Text Available Objective – The purpose of this paper is to articulate a theory for the use of action research as a tool of evidence based practice for information literacy instruction in school libraries. The emerging theory is intended to capture the complex phenomenon of information skills teaching as it is embedded in school curricula. Such a theory is needed to support research on the integrated approach to teaching information skills and knowledge construction within the framework of inquiry learning. Part 1 of this paper, in the previous issue, built a foundation for emerging theory, which established user‐centric information behavior and constructivist learning theory as the substantive theory behind evidence based library instruction in schools. Part 2 continues to build on the Information Search Process and Guided Inquiry as foundational to studying the information‐to‐knowledge connection and the concepts of help and intervention characteristic of 21st century school library instruction.Methods – This paper examines the purpose and methodology of action research as a tool of evidence based instruction. This is accomplished through the explication of three components of theory‐building: paradigm, substantive research, and metatheory. Evidence based practice is identified as the paradigm that contributes values and assumptions about school library instruction. It establishes the role of evidence in teaching and learning, linking theory and practice. Action research, as a tool of evidence based practice is defined as the synthesis of authentic learning, or performance‐based assessment practices that continuously generate evidence throughout the inquiry unit of instruction and traditional data collection methods typically used in formal research. This paper adds social psychology theory from Lewin’s work, which contributes methodology from Gestalt psychology, field theory, group dynamics, and change theory. For Lewin the purpose of action

  5. Emerging Evidence for Instructional Practice: Repeated Viewings of Sign Language Models

    Science.gov (United States)

    Beal-Alvarez, Jennifer S.; Huston, Sandra G.

    2014-01-01

    Current initiatives in education, such as No Child Left Behind and the National Common Core Standards movement, call for the use of evidence-based practices, or those instructional practices that are supported by documentation of their effectiveness related to student learning outcomes, including students with special needs. While hearing loss is…

  6. Family presence during trauma activations and medical resuscitations in a pediatric emergency department: an evidence-based practice project.

    Science.gov (United States)

    Kingsnorth, Jennifer; O'Connell, Karen; Guzzetta, Cathie E; Edens, Jacki Curreri; Atabaki, Shireen; Mecherikunnel, Anne; Brown, Kathleen

    2010-03-01

    The existing family presence literature indicates that implementation of a family presence policy can result in positive outcomes. The purpose of our evidence-based practice project was to evaluate a family presence intervention using the 6 A's of the evidence cycle (ask, acquire, appraise, apply, analyze, and adopt/adapt). For step 1 (ask), we propose the following question: Is it feasible to implement a family presence intervention during trauma team activations and medical resuscitations in a pediatric emergency department using national guidelines to ensure appropriate family member behavior and uninterrupted patient care? Regarding steps 2 through 4 (acquire, appraise, and apply), our demonstration project was conducted in a pediatric emergency department during the implementation of a new family presence policy. Our family presence intervention incorporated current appraisal of literature and national guidelines including family screening, family preparation, and use of family presence facilitators. We evaluated whether it was feasible to implement the steps of our intervention and whether the intervention was safe in ensuring uninterrupted patient care. With regard to step 5 (analyze), family presence was evaluated in 106 events, in which 96 families were deemed appropriate and chose to be present. Nearly all families (96%) were screened before entering the room, and all were deemed appropriate candidates. Facilitators guided the family during all events. One family presence event was terminated. In all cases patient care was not interrupted. Regarding step 6 (adopt/adapt), our findings document the feasibility of implementing a family presence intervention in a pediatric emergency department while ensuring uninterrupted patient care. We have adopted family presence as a standard practice. This project can serve as the prototype for others. Copyright (c) 2010 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  7. Physician work intensity among medical specialties: emerging evidence on its magnitude and composition.

    Science.gov (United States)

    Horner, Ronnie D; Szaflarski, Jerzy P; Ying, Jun; Meganathan, Karthikeyan; Matthews, Gerald; Schroer, Brian; Weber, Debra; Raphaelson, Marc

    2011-11-01

    Similarities and differences in physician work intensity among specialties are poorly understood but have implications for quality of care, patient safety, practice organization and management, and payment. To determine the magnitude and important dimensions of physician work intensity for 4 specialties. Cross-sectional assessment of work intensity associated with actual patient care in the examination room or operating room. A convenience sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons, located in Kansas, Kentucky, Maryland, Ohio, and Virginia. Work intensity measures included the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), Subjective Work Assessment Technique (SWAT), and Multiple Resource Questionnaire. Stress was measured by the Dundee Stress State Questionnaire. Physicians reported similar magnitude of work intensity on the NASA-TLX and Multiple Resource Questionnaire. On the SWAT, general internists reported work intensity similar to surgeons but significantly lower than family physicians and neurologists (P=0.035). Surgeons reported significantly higher levels of task engagement on the stress measure than the other specialties (P=0.019), significantly higher intensity on physical demand (P NASA-TLX than the other specialties (P=0.003). Surgeons reported the lowest intensity for temporal demand of all specialties, being significantly lower than either family physicians or neurologists (P=0.014). Family physicians reported the highest intensity on the time dimension of the SWAT, being significantly higher than either general internists or surgeons (P=0.008). Level of physician work intensity seems to be similar among specialties.

  8. Trade Openness and Bank Risk-Taking Behavior: Evidence from Emerging Economies

    Directory of Open Access Journals (Sweden)

    Badar Nadeem Ashraf

    2017-07-01

    Full Text Available In this paper, we examine the impact of trade openness on bank risk-taking behavior. Using a panel dataset of 291 banks from 37 emerging countries over the period from 1998 to 2012, we find that higher trade openness decreases bank risk-taking. The results are robust when we use alternative bank risk-taking proxies and alternative estimation methods. We argue that trade openness provides diversification opportunities to banks in lending activities, which decrease overall bank risk. Further to this end, we observe that higher trade openness helps domestic banks to smooth out income volatility and decreases the impact of a financial crisis on banks.

  9. The causal dynamics between coal consumption and growth: Evidence from emerging market economies

    International Nuclear Information System (INIS)

    Apergis, Nicholas; Payne, James E.

    2010-01-01

    This study examines the relationship between coal consumption and economic growth for 15 emerging market economies within a multivariate panel framework over the period 1980-2006. The heterogeneous panel cointegration results indicate there is a long-run equilibrium relationship between real GDP, coal consumption, real gross fixed capital formation, and the labor force. While in the long-run both real gross fixed capital formation and the labor force have a significant positive impact on real GDP, coal consumption has a significant negative impact. The panel causality tests show bidirectional causality between coal consumption and economic growth in both the short- and long-run. (author)

  10. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  11. [Accidents and violence in childhood: survey evidence of emergency care for external causes--Brazil, 2009].

    Science.gov (United States)

    Malta, Deborah Carvalho; Mascarenhas, Márcio Dênis Medeiros; Bernal, Regina Tomie Ivata; Viegas, Anna Paula Bise; de Sá, Naiza Nayla Bandeira; da Silva Junior, Jarbas Barbosa

    2012-09-01

    Understanding the characteristics and magnitude of accidents and violence due to external causes in children from 0 to 9 years of age is becoming ever more important in Public Health. The scope of this paper was to analyze emergency care for accidents due to external causes in children. The Sentinel Urgency and Emergency Services of the Violence and Accident Vigilance System (VIVA Survey), performed in 74 urgency services in the Federal District and 23 State capitals in 2009 was used. Data of 7,123 children were analyzed: 6,897 (96.7%) victims of accidents and 226 (3.3%) of violence. In comparison with victims of violence, the visits for accidents were more frequent among white children from 2 to 5 years old occurring in the home (p accidents, falls and burns predominated in the 0 to 1group, while traffic accidents were most frequent in the 6 to 9-year-old age group (p < 0.001). With respect to violence, the visits for neglect and physical assault predominated, respectively, in extreme age groups, with someone in the family being the perpetrator (p < 0.001). Information on the occurrence of external causes in children may support health promotion policies, besides guiding health professionals, teachers and families in the prevention of such causes.

  12. Extreme value theory in emerging markets: Evidence from the Montenegrin stock exchange

    Directory of Open Access Journals (Sweden)

    Cerović Julija

    2015-01-01

    Full Text Available The concept of Value at Risk(VaR estimates the maximum loss of a financial position at a given time for a given probability. This paper considers the adequacy of the methods that are the basis of extreme value theory in the Montenegrin emerging market before and during the global financial crisis. In particular, the purpose of the paper is to investigate whether the peaks-over-threshold method outperforms the block maxima method in evaluation of Value at Risk in emerging stock markets such as the Montenegrin market. The daily return of the Montenegrin stock market index MONEX20 is analyzed for the period January 2004 - February 2014. Results of the Kupiec test show that the peaks-over-threshold method is significantly better than the block maxima method, but both methods fail to pass the Christoffersen independence test and joint test due to the lack of accuracy in exception clustering when measuring Value at Risk. Although better, the peaks-over-threshold method still cannot be treated as an accurate VaR model for the Montenegrin frontier stock market.

  13. From Closed to Open Innovation in Emerging Economies: Evidence from the Chemical Industry in Brazil

    Directory of Open Access Journals (Sweden)

    Elisa Thomas

    2018-03-01

    Full Text Available In this article, we examine how firms in an emerging economy perform research and development (R&D activities in regards to the concept of open innovation. Most literature on open innovation shows multinational knowledge-intensive firms with well-established R&D processes mainly in developed countries. Searching for management contributions for firms in emerging economies, we qualitatively analyzed two chemical firms in Southern Brazil that have different profiles and are representative samples of typical firms in the region. Our results show that firms did not fully exploit the potential benefits brought by open innovation, even when complete opening was not the main goal. The firms were similar concerning interactions with partners and stages where relationships occur. The generation of ideas was an open activity performed both by firms and by clients, and interactions with universities were getting stronger. On the other hand, intellectual property has not been used as means of profiting from innovation activities. Our main finding refers to the internal mediation of relationships with partners. R&D teams rarely contact external organizations directly; instead, they leave such interactions to other departments within their firms. Relationships with clients are mediated through technical and commercial departments, and interactions with suppliers are intermediated by the supply staff.

  14. Forward-Looking Beta Estimates:Evidence from an Emerging Market

    OpenAIRE

    Onour, Ibrahim

    2008-01-01

    Results in this paper support evidence of time-varying beta coefficients for five sectors in Kuwait Stock Market. The paper indicates banks, food, and service sectors exhibit relatively wider range of variation compared to industry and real estate sectors. Results of time-varying betas invalidate the standard application of Capital Asset Pricing model that assumes constant beta. In terms of risk exposure, banks and industrial sectors reflect higher risk as their average betas exceed the mark...

  15. Relationship between oil prices, interest rate, and unemployment. Evidence from an emerging market

    International Nuclear Information System (INIS)

    Dogrul, H. Guensel; Soytas, Ugur

    2010-01-01

    While the interrelation between oil price changes, economic activity and employment is an important issue that has been studied mainly for developed countries, little attention has been devoted to inquiries on fluctuations in the price of crude oil and its impact on employment for small open economies. Adopting an efficiency wage model for equilibrium employment that does not require any assumptions regarding labor supply, this paper contributes to the literature by investigating the causality between unemployment and two input prices, namely energy (crude oil) and capital (real interest rate) in an emerging market, Turkey for the period 2005:01-2009:08. Applying a relatively new technique, the Toda-Yamamoto procedure, we find that the real price of oil and interest rate improve the forecasts of unemployment in the long run. This finding supports the hypothesis that labor is a substitute factor of production for capital and energy. (author)

  16. OIL MARKET, NUCLEAR ENERGY CONSUMPTION AND ECONOMIC GROWTH: EVIDENCE FROM EMERGING ECONOMIES

    Directory of Open Access Journals (Sweden)

    Hanan Naser

    2014-04-01

    Full Text Available This paper empirically examines the relationship between oil consumption, nuclear energy consumption, oil price and economic growth in four emerging economies (Russia, China, South Korea, and India over the period from 1965 to 2010. Applying a modified version of the granger causality test developed by Toda and Yamamoto, we find that the level of world crude oil prices (WTI plays a crucial role in determining the economic growth in the investigated countries. The results suggest that there is a unidirectional causality running from real GDP to oil consumption in China and South Korea, while bidirectional relationship between oil consumption and real GDP growth appears in India. Furthermore, the results propose that while nuclear energy stimulates economic growth in both South Korea and India, the rapid increase in China economic growth requires additional usage of nuclear energy.

  17. Spectropolarimetric Evidence for a Siphon Flow along an Emerging Magnetic Flux Tube

    Energy Technology Data Exchange (ETDEWEB)

    Requerey, Iker S.; Cobo, B. Ruiz [Instituto de Astrofísica de Canarias, Vía Láctea s/n, E-38205 La Laguna, Tenerife (Spain); Iniesta, J. C. Del Toro; Suárez, D. Orozco [Instituto de Astrofísica de Andalucía (CSIC), Apdo. de Correos 3004, E-18080 Granada (Spain); Rodríguez, J. Blanco [Grupo de Astronomía y Ciencias del Espacio, Universidad de Valencia, E-46980 Paterna, Valencia (Spain); Solanki, S. K.; Barthol, P.; Gandorfer, A.; Gizon, L.; Hirzberger, J.; Riethmüller, T. L.; Noort, M. van [Max-Planck-Institut für Sonnensystemforschung, Justus-von-Liebig-Weg 3, D-37077 Göttingen (Germany); Schmidt, W. [Kiepenheuer-Institut für Sonnenphysik, Schöneckstr. 6, D-79104 Freiburg (Germany); Pillet, V. Martínez [National Solar Observatory, 3665 Discovery Drive, Boulder, CO 80303 (United States); Knölker, M., E-mail: iker@iac.es [High Altitude Observatory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307-3000 (United States)

    2017-03-01

    We study the dynamics and topology of an emerging magnetic flux concentration using high spatial resolution spectropolarimetric data acquired with the Imaging Magnetograph eXperiment on board the sunrise balloon-borne solar observatory. We obtain the full vector magnetic field and the line of sight (LOS) velocity through inversions of the Fe i line at 525.02 nm with the SPINOR code. The derived vector magnetic field is used to trace magnetic field lines. Two magnetic flux concentrations with different polarities and LOS velocities are found to be connected by a group of arch-shaped magnetic field lines. The positive polarity footpoint is weaker (1100 G) and displays an upflow, while the negative polarity footpoint is stronger (2200 G) and shows a downflow. This configuration is naturally interpreted as a siphon flow along an arched magnetic flux tube.

  18. Accelerated Internationalization in Emerging Markets: Empirical Evidence from Brazilian Technology-Based Firms

    Directory of Open Access Journals (Sweden)

    Fernanda Ferreira Ribeiro

    2014-04-01

    Full Text Available This paper offers an analysis into the external factors influencing the accelerated internationalization of technology-based firms (TBFs in the context of an emerging country, Brazil. This type of firm is typically called born global and has been reported mainly in high technology sectors and from developed countries. A survey was applied to small and medium Brazilian TBFs. Logistic regression was used to test the research hypotheses. The results suggest that new and small Brazilian technology-based firms, which followed an accelerated internationalization process, are most likely to be integrated into a global production chain. Results also show that TBFs which take more than five years to enter the international market, benefit more from the location in an innovation habitat, the partnerships in the home country, and the pro-internationalization government policies. Therefore, this research contributes to a better understanding of the phenomenon and points to new perspectives of studies.

  19. Medical Management of Endometriosis: Emerging Evidence Linking Inflammation to Disease Pathophysiology

    Science.gov (United States)

    Bruner-Tran, Kaylon L.; Herington, Jennifer L.; Duleba, Antoni J.; Taylor, Hugh S.; Osteen, Kevin G.

    2013-01-01

    Progesterone action normally mediates the balance between anti-inflammatory and pro-inflammatory processes throughout the female reproductive tract. However, in women with endometriosis, endometrial progesterone resistance, characterized by alterations in progesterone responsive gene and protein expression, is now considered a central element in disease pathophysiology. Recent studies additionally suggest that the peritoneal microenvironment of endometriosis patients exhibits altered physiological characteristics that may further promote inflammation-driven disease development and progression. Within this review, we summarize our current understanding of the pathogenesis of endometriosis with an emphasis on the role that inflammation plays in generating not only the progesterone-resistant eutopic endometrium but also a peritoneal microenvironment that may contribute significantly to disease establishment. Viewing endometriosis from the emerging perspective that a progesterone resistant endometrium and an immunologically compromised peritoneal microenvironment are biologically linked risk factors for disease development provides a novel mechanistic framework to identify new therapeutic targets for appropriate medical management. PMID:23598784

  20. DETERMINANTS OF GROWTH IN FRANCHISING CONTRACTS IN EMERGING MARKETS; EVIDENCES FROM TURKEY

    Directory of Open Access Journals (Sweden)

    Sitki Sonmezer

    2012-02-01

    Full Text Available This study aims to examine the franchise sector and determine the significant factors that contribute to an increase in the number of franchiser’s contracts in Turkey. Secondary data is used from the Turkish Franchise Association and multivariate regression models are run for each sector. Our models explain the change in the number of franchise contracts with R2’s varying between .6577 and .7549. We provide evidence that success factors in increasing the number of contracts change depending on the sector firms operating in and contracts may be designed thusly to pursue success.

  1. Use of Banking Services in Emerging Markets - Household-Level Evidence

    OpenAIRE

    Brown, Martin; Beck, Thorsten

    2011-01-01

    This paper uses survey data for 60,000 households from 29 transition economies in 2006 and 2010 to explore how the use of banking services is related to household characteristics, as well as to bank ownership, deposit insurance and creditor protection. At the household level we find that the holding of a bank account, a bank card, or a mortgage increases with income and education in most countries and find evidence for an urban-rural gap. The use of banking services is also related to the rel...

  2. Estimating Short run and Long run Coefficients of Fundamentals Factors with Growth and Momentum Factor: Evidence from Emerging Markets

    Directory of Open Access Journals (Sweden)

    Adnan Shoaib

    2016-12-01

    Full Text Available This study examines the long term relationship of risk premium and fundamental factors in emerging stock markets of China, India and Pakistan keeping in view leading contribution of Fama and French (1992 and Carhart (1997 models. Contrary to the macroeconomic multifactor models, this study incorporates firm-specific risk factors related to the market premium; size (SMB, value (HML, momentum (WML and growth (UMD as determinants of risk premium. The firm-specific growth factor is incorporated based on evidence from Ho, Strange, and Piesse (2008 by employing (UMD which is based on assets to market equity of the firm. Sample of 1198 companies from the three emerging markets for the period of 2001-2013 depicts market risk premium as the leading factor affecting risk premium in Indian and the Pakistani markets. Results reveal market momentum being high enough to overestimate coefficients in the short run. However, the relationship is stabilized and adjusted in the long run. Chinese markets, where all the risk factors seem to play their role to determine risk premium, are relatively much stable and grown-up and clearly represent maturity of the Chinese markets. Distinction between the short run and long run might be useful for the investors of the three emerging economies. According to the principle of high risk associated with high returns, small value happens to deliver higher returns with higher volatility. The growth stocks outperform value stocks in these economies.

  3. Laying a Firm Foundation: Embedding Evidence-Based Emergent Literacy Practices Into Early Intervention and Preschool Environments.

    Science.gov (United States)

    Terrell, Pamela; Watson, Maggie

    2018-04-05

    As part of this clinical forum on curriculum-based intervention, the goal of this tutorial is to share research about the importance of language and literacy foundations in natural environments during emergent literacy skill development, from infancy through preschool. Following an overview of intervention models in schools by Powell (2018), best practices at home, in child care, and in preschool settings are discussed. Speech-language pathologists in these settings will be provided a toolbox of best emergent literacy practices. A review of published literature in speech-language pathology, early intervention, early childhood education, and literacy was completed. Subsequently, an overview of the impact of early home and preschool literacy experiences are described. Research-based implementation of best practice is supported with examples of shared book reading and child-led literacy embedded in play within the coaching model of early intervention. Finally, various aspects of emergent literacy skill development in the preschool years are discussed. These include phonemic awareness, print/alphabet awareness, oral language skills, and embedded/explicit literacy. Research indicates that rich home literacy environments and exposure to rich oral language provide an important foundation for the more structured literacy environments of school. Furthermore, there is a wealth of evidence to support a variety of direct and indirect intervention practices in the home, child care, and preschool contexts to support and enhance all aspects of oral and written literacy. Application of this "toolbox" of strategies should enable speech-language pathologists to address the prevention and intervention of literacy deficits within multiple environments during book and play activities. Additionally, clinicians will have techniques to share with parents, child care providers, and preschool teachers for evidence-based literacy instruction within all settings during typical daily

  4. Increasing convergence between imagined and executed movement across development: evidence for the emergence of movement representations.

    Science.gov (United States)

    Caeyenberghs, Karen; Wilson, Peter H; van Roon, Dominique; Swinnen, Stephan P; Smits-Engelsman, Bouwien C M

    2009-04-01

    Motor imagery (MI) has become a principal focus of interest in studies on brain and behavior. However, changes in MI across development have received virtually no attention so far. In the present study, children (N = 112, 6 to 16 years old) performed a new, computerized Virtual Radial Fitts Task (VRFT) to determine their MI ability as well as the age-related confluence between performance in executed and imagined movement conditions. Participants aimed at five targets, which were positioned along radial axes from a central target circle. The targets differed in width (2.5, 5, 10, 20 or 40 mm), resulting in an index of difficulty (ID) that varied from 6.9 to 2.9 bits. Performance was indexed by the linear relationship between ID and Movement Time (MT). The findings showed that executed task performance was slower than imagined performance. Moreover, conformance to Fitts' Law during executed movement performance was obtained from a very young age. Most importantly, correlations between imagined and executed movements were low in the young participants but gradually increased across age. These age-related changes in MI are hypothesized to reflect the children's emerging ability to represent internal models for prospective actions, consistent with the gradual unfolding of feedforward control processes.

  5. The nervous system and metabolic dysregulation: emerging evidence converges on ketogenic diet therapy

    Directory of Open Access Journals (Sweden)

    David N. Ruskin

    2012-03-01

    Full Text Available A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high-fat, low-carbohydrate ketogenic diet debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, ketogenic diet therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. More recently, cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders - although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a ketogenic diet and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a ketogenic diet on cognition and recent data on the effects of a ketogenic diet on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system.

  6. Tracking the emergence of the consonant bias in visual-word recognition: evidence with developing readers.

    Science.gov (United States)

    Soares, Ana Paula; Perea, Manuel; Comesaña, Montserrat

    2014-01-01

    Recent research with skilled adult readers has consistently revealed an advantage of consonants over vowels in visual-word recognition (i.e., the so-called "consonant bias"). Nevertheless, little is known about how early in development the consonant bias emerges. This work aims to address this issue by studying the relative contribution of consonants and vowels at the early stages of visual-word recognition in developing readers (2(nd) and 4(th) Grade children) and skilled adult readers (college students) using a masked priming lexical decision task. Target words starting either with a consonant or a vowel were preceded by a briefly presented masked prime (50 ms) that could be the same as the target (e.g., pirata-PIRATA [pirate-PIRATE]), a consonant-preserving prime (e.g., pureto-PIRATA), a vowel-preserving prime (e.g., gicala-PIRATA), or an unrelated prime (e.g., bocelo -PIRATA). Results revealed significant priming effects for the identity and consonant-preserving conditions in adult readers and 4(th) Grade children, whereas 2(nd) graders only showed priming for the identity condition. In adult readers, the advantage of consonants was observed both for words starting with a consonant or a vowel, while in 4(th) graders this advantage was restricted to words with an initial consonant. Thus, the present findings suggest that a Consonant/Vowel skeleton should be included in future (developmental) models of visual-word recognition and reading.

  7. The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy

    Science.gov (United States)

    Ruskin, David N.; Masino, Susan A.

    2012-01-01

    A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high fat, low-carbohydrate ketogenic diet (KD) debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, KD therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. Cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders – although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a KD and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a KD on cognition and recent data on the effects of a KD on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system. PMID:22470316

  8. Investor’s Sentiments and Stock Market Volatility: an empirical evidence from emerging stock market

    Directory of Open Access Journals (Sweden)

    Mobeen Ur Rehman

    2013-05-01

    Full Text Available The concept of efficient market hypothesis has prevailed the financial markets for a long time which says that the prices of the securities reflect all available information. This approach was mainly followed by the rational investors but with the passage of time, the concept of behavioral finance emerged due to some of the major global financial crashes. This concept states that there are investors trading in the market making decisions on the basis of sentiments not on any fundamental information. Such class of traders is called the noise traders and they are mainly responsible for any disruption in the returns of the securities. In this paper we will try to find whether these sentiments of the investors affect the returns of the securities listed on the Karachi stock exchange. We will use the investor sentiment index that uses the six proxies the data on which has been collected mainly from the Karachi stock exchange. Volatility of the stock market returns will be calculated and regressed with the sentimental equation discussed above as the independent variable. This study will help us to find out the extent to which these sentiments influence the stock market returns in weak form efficient market and also it will help us to identify the presence of such irrational noise traders in our financial market.

  9. Value-at-risk estimation with wavelet-based extreme value theory: Evidence from emerging markets

    Science.gov (United States)

    Cifter, Atilla

    2011-06-01

    This paper introduces wavelet-based extreme value theory (EVT) for univariate value-at-risk estimation. Wavelets and EVT are combined for volatility forecasting to estimate a hybrid model. In the first stage, wavelets are used as a threshold in generalized Pareto distribution, and in the second stage, EVT is applied with a wavelet-based threshold. This new model is applied to two major emerging stock markets: the Istanbul Stock Exchange (ISE) and the Budapest Stock Exchange (BUX). The relative performance of wavelet-based EVT is benchmarked against the Riskmetrics-EWMA, ARMA-GARCH, generalized Pareto distribution, and conditional generalized Pareto distribution models. The empirical results show that the wavelet-based extreme value theory increases predictive performance of financial forecasting according to number of violations and tail-loss tests. The superior forecasting performance of the wavelet-based EVT model is also consistent with Basel II requirements, and this new model can be used by financial institutions as well.

  10. Periodontal manifestations of inflammatory bowel disease: emerging epidemiologic and biologic evidence.

    Science.gov (United States)

    Agossa, K; Dendooven, A; Dubuquoy, L; Gower-Rousseau, C; Delcourt-Debruyne, E; Capron, M

    2017-06-01

    Inflammatory bowel disease and periodontitis are both described as a disproportionate mucosal inflammatory response to a microbial environment in susceptible patients. Moreover, these two conditions share major environmental and lifestyle-related risk factors. Despite this intriguing pathogenic parallel, large-scale studies and basic research have only recently considered periodontal outcomes as relevant data. There are mounting and consistent arguments, from recent epidemiologic studies and animal models, that these two conditions might be related. This article is a comprehensive and critical up-to-date review of the current evidence and future prospects in understanding the biologic and epidemiologic relationships between periodontal status and inflammatory bowel disease. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Asbestos exposure and health hazards: a global emergency, Epidemiological evidence and denial theories

    Directory of Open Access Journals (Sweden)

    Francesca Zazzara

    2013-11-01

    Full Text Available On June 3rd 2013, in Turin, Italy, the Swiss industrialist Schmidheiny has been sentenced to 18 years imprisonment for intentional disaster for 3,000 asbestos-linked tumours in Italian workers at cement multinational Eternit. The indiscriminate use of asbestos, however, continues worldwide. Although many studies have shown that asbestos is associated with an increased risk of mortality and morbidity, denial theories were spread over time, showing how the logic of profit governs the production of asbestos. We examined the history of the epidemiological evidence of asbestos related risks and, second, the main sources of exposure in Italy and in the world, occupational, non-occupational, and post-disaster exposure (as occurred after L’Aquila earthquake in April 2009. The theme of inequality and social justice is ever so alarming in the fight against asbestos and its lobbies.

  12. Emergence of Wealth Inequality in China: Evidence from Rural Household Survey, 1986 -2000

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    Kyeongwon Yoo

    2003-12-01

    Full Text Available Based on relatively recent household survey data (1986 2000 in rural China, this paper analyzes the composition and inequality in non-land wealth. We first document the evolution of rural households wealth during the sample period. Our results show that the housing assets have played a dominant role in their wealth composition although the share of the assets tends to decrease during the period. We also observe that financial and fixed assets have become relatively important in their wealth composition. Based on various inequality measures we are able to provide consistent evidence that the inequality of wealth distribution has worsened in rural China. We find that financial asset holdings appear to have significant unequalizing effect on the total non-land wealth distribution, mostly due to the growing differential in rural non-farm opportunities.

  13. Probing for Neuroadaptations to Unpredictable Stressors in Addiction: Translational Methods and Emerging Evidence

    Science.gov (United States)

    Kaye, Jesse T.; Bradford, Daniel E.; Magruder, Katherine P.; Curtin, John J.

    2017-01-01

    Stressors clearly contribute to addiction etiology and relapse in humans, but our understanding of specific mechanisms remains limited. Rodent models of addiction offer the power, flexibility, and precision necessary to delineate the causal role and specific mechanisms through which stressors influence alcohol and other drug use. This review describes a program of research using startle potentiation to unpredictable stressors that is well positioned to translate between animal models and clinical research with humans on stress neuroadaptations in addiction. This research rests on a solid foundation provided by three separate pillars of evidence from (a) rodent behavioral neuroscience on stress neuroadaptations in addiction, (b) rodent affective neuroscience on startle potentiation, and (c) human addiction and affective science with startle potentiation. Rodent stress neuroadaptation models implicate adaptations in corticotropin-releasing factor and norepinephrine circuits within the central extended amygdala following chronic alcohol and other drug use that mediate anxious behaviors and stress-induced reinstatement among drug-dependent rodents. Basic affective neuroscience indicates that these same neural mechanisms are involved in startle potentiation to unpredictable stressors in particular (vs. predictable stressors). We believe that synthesis of these evidence bases should focus us on the role of unpredictable stressors in addiction etiology and relapse. Startle potentiation in unpredictable stressor tasks is proposed to provide an attractive and flexible test bed to encourage tight translation and reverse translation between animal models and human clinical research on stress neuroadaptations. Experimental therapeutics approaches focused on unpredictable stressors hold high promise to identify, repurpose, or refine pharmacological and psychosocial interventions for addiction. PMID:28499100

  14. Probing for Neuroadaptations to Unpredictable Stressors in Addiction: Translational Methods and Emerging Evidence.

    Science.gov (United States)

    Kaye, Jesse T; Bradford, Daniel E; Magruder, Katherine P; Curtin, John J

    2017-05-01

    Stressors clearly contribute to addiction etiology and relapse in humans, but our understanding of specific mechanisms remains limited. Rodent models of addiction offer the power, flexibility, and precision necessary to delineate the causal role and specific mechanisms through which stressors influence alcohol and other drug use. This review describes a program of research using startle potentiation to unpredictable stressors that is well positioned to translate between animal models and clinical research with humans on stress neuroadaptations in addiction. This research rests on a solid foundation provided by three separate pillars of evidence from (a) rodent behavioral neuroscience on stress neuroadaptations in addiction, (b) rodent affective neuroscience on startle potentiation, and (c) human addiction and affective science with startle potentiation. Rodent stress neuroadaptation models implicate adaptations in corticotropin-releasing factor and norepinephrine circuits within the central extended amygdala following chronic alcohol and other drug use that mediate anxious behaviors and stress-induced reinstatement among drug-dependent rodents. Basic affective neuroscience indicates that these same neural mechanisms are involved in startle potentiation to unpredictable stressors in particular (vs. predictable stressors). We believe that synthesis of these evidence bases should focus us on the role of unpredictable stressors in addiction etiology and relapse. Startle potentiation in unpredictable stressor tasks is proposed to provide an attractive and flexible test bed to encourage tight translation and reverse translation between animal models and human clinical research on stress neuroadaptations. Experimental therapeutics approaches focused on unpredictable stressors hold high promise to identify, repurpose, or refine pharmacological and psychosocial interventions for addiction.

  15. Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence.

    Science.gov (United States)

    Kerr, Jacqueline; Anderson, Cheryl; Lippman, Scott M

    2017-08-01

    The lifestyle factors of physical activity, sedentary behaviour, and diet are increasingly being studied for their associations with cancer. Physical activity is inversely associated with and sedentary behaviour is positively (and independently) associated with an increased risk of more than ten types of cancer, including colorectal cancer (and advanced adenomas), endometrial cancers, and breast cancer. The most consistent dietary risk factor for premalignant and invasive breast cancer is alcohol, whether consumed during early or late adult life, even at low levels. Epidemiological studies show that the inclusion of wholegrain, fibre, fruits, and vegetables within diets are associated with reduced cancer risk, with diet during early life (age diet-related factors have not yet shown any conclusive associations between diet and cancer incidence. Obesity is a key contributory factor associated with cancer risk and mortality, including in dose-response associations in endometrial and post-menopausal breast cancer, and in degree and duration of fatty liver disease-related hepatocellular carcinoma. Obesity produces an inflammatory state, characterised by macrophages clustered around enlarged hypertrophied, dead, and dying adipocytes, forming crown-like structures. Increased concentrations of aromatase and interleukin 6 in inflamed breast tissue and an increased number of macrophages, compared with healthy tissue, are also observed in women with normal body mass index, suggesting a metabolic obesity state. Emerging randomised controlled trials of physical activity and dietary factors and mechanistic studies of immunity, inflammation, extracellular matrix mechanics, epigenetic or transcriptional regulation, protein translation, circadian disruption, and interactions of the multibiome with lifestyle factors will be crucial to advance this field. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Toys in the upper aerodigestive tract: evidence on their risk as emerging from the ESFBI study.

    Science.gov (United States)

    Foltran, Francesca; Gregori, Dario; Passàli, Desiderio; Bellussi, Luisa; Caruso, Giuseppe; Passàli, Francesco Maria; Passàli, Giulio Cesare

    2011-10-01

    Foreign body inhalation/aspiration or ingestion is a relatively common event in young children and, despite many efforts made in several Countries to reach acceptable safety levels for products devoted to children, small toys or toy parts are frequently mentioned among risky foreign bodies. The aim of the present study is to characterize the risk of complications and prolonged hospitalization due to toys inhalation/aspiration or ingestion according to age and gender of patients, FB characteristics and FB location, circumstances of the accident, as emerging from the ESFBI study. A retrospective study in major hospitals of 19 European Countries was realized on children aged 0-14 having inhaled/aspired or ingested a toy, with regard to the characteristics of the child and the FB (shape, volume, consistency), the FB location, the hospitalization's details and the occurrence of complications. In the years 2000-2003 a total of 2094 FB injuries occurred in children aged 0-14 years. Among them 121 (5.8%) were due to toys (mainly parts of toys) and 95 (4.5%) occurred in the lower/upper aero-digestive tract. 58 children needed hospitalization. The first determinant of a damage requiring hospitalization is the rigid consistence of the object. Almost 27% of toys related injuries happened under adults' supervision. Despite the adoption of preventive strategies, including products modification by manufacturers, has resulted in a decrease of children's mortality rate for choking in the last decades, our results seem to testify that preventive strategies imposing a regulation of industrial production, even if fundamental, are not sufficient and need to be integrated with other preventive intervention addressed to improve parents ability to be conscious of FB injuries and attentive toward a proper surveillance of children. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. The relationship between the nucleolus and cancer: Current evidence and emerging paradigms.

    Science.gov (United States)

    Orsolic, Ines; Jurada, Deana; Pullen, Nick; Oren, Moshe; Eliopoulos, Aristides G; Volarevic, Sinisa

    2016-06-01

    The nucleolus is the most prominent nuclear substructure assigned to produce ribosomes; molecular machines that are responsible for carrying out protein synthesis. To meet the increased demand for proteins during cell growth and proliferation the cell must increase protein synthetic capacity by upregulating ribosome biogenesis. While larger nucleolar size and number have been recognized as hallmark features of many tumor types, recent evidence has suggested that, in addition to overproduction of ribosomes, decreased ribosome biogenesis as well as qualitative changes in this process could also contribute to tumor initiation and cancer progression. Furthermore, the nucleolus has become the focus of intense attention for its involvement in processes that are clearly unrelated to ribosome biogenesis such as sensing and responding to endogenous and exogenous stressors, maintenance of genome stability, regulation of cell-cycle progression, cellular senescence, telomere function, chromatin structure, establishment of nuclear architecture, global regulation of gene expression and biogenesis of multiple ribonucleoprotein particles. The fact that dysregulation of many of these fundamental cellular processes may contribute to the malignant phenotype suggests that normal functioning of the nucleolus safeguards against the development of cancer and indicates its potential as a therapeutic approach. Here we review the recent advances made toward understanding these newly-recognized nucleolar functions and their roles in normal and cancer cells, and discuss possible future research directions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Content-Based Instruction Understood in Terms of Connectionism and Constructivism

    Science.gov (United States)

    Lain, Stephanie

    2016-01-01

    Despite the number of articles devoted to the topic of content-based instruction (CBI), little attempt has been made to link the claims for CBI to research in cognitive science. In this article, I review the CBI model of foreign language (FL) instruction in the context of its close alignment with two emergent frameworks in cognitive science:…

  19. Treatment of Anabolic-Androgenic Steroid Dependence: Emerging Evidence and Its Implications

    Science.gov (United States)

    Kanayama, Gen; Brower, Kirk J.; Wood, Ruth I.; Hudson, James I.; Pope, Harrison G.

    2010-01-01

    Currently, few users of anabolic-androgenic steroids (AAS) seek substance-abuse treatment. But this picture may soon change substantially, because illicit AAS use did not become widespread until the 1980s, and consequently the older members of this AAS-using population—those who initiated AAS as youths in the 1980s—are only now reaching middle age. Members of this group, especially those who have developed AAS dependence, may therefore be entering the age of risk for cardiac and psychoneuroendocrine complications sufficient to motivate them for substance-abuse treatment. We suggest that this treatment should address at least three etiologic mechanisms by which AAS dependence might develop. First, individuals with body-image disorders such as “muscle dysmorphia” may become dependent on AAS for their anabolic effects; these body-image disorders may respond to psychological therapies or pharmacologic treatments. Second, AAS suppress the male hypothalamic-pituitary-gonadal axis via their androgenic effects, potentially causing hypogonadism during AAS withdrawal. Men experiencing prolonged dysphoric effects or frank major depression from hypogonadism may desire to resume AAS, thus contributing to AAS dependence. AAS-induced hypogonadism may require treatment with human chorionic gonadotropin or clomiphene to reactivate neuroendocrine function, and may necessitate antidepressant treatments in cases of depression inadequately responsive to endocrine therapies alone. Third, human and animal evidence indicates that AAS also possess hedonic effects, which likely promote dependence via mechanisms shared with classical addictive drugs, especially opioids. Indeed, the opioid antagonist naltrexone blocks AAS dependence in animals. By inference, pharmacological and psychosocial treatments for human opioid dependence might also benefit AAS-dependent individuals. PMID:20188494

  20. Treatment of anabolic-androgenic steroid dependence: Emerging evidence and its implications.

    Science.gov (United States)

    Kanayama, Gen; Brower, Kirk J; Wood, Ruth I; Hudson, James I; Pope, Harrison G

    2010-06-01

    Currently, few users of anabolic-androgenic steroids (AAS) seek substance abuse treatment. But this picture may soon change substantially, because illicit AAS use did not become widespread until the 1980s, and consequently the older members of this AAS-using population - those who initiated AAS as youths in the 1980s - are only now reaching middle age. Members of this group, especially those who have developed AAS dependence, may therefore be entering the age of risk for cardiac and psychoneuroendocrine complications sufficient to motivate them for substance abuse treatment. We suggest that this treatment should address at least three etiologic mechanisms by which AAS dependence might develop. First, individuals with body image disorders such as "muscle dysmorphia" may become dependent on AAS for their anabolic effects; these body image disorders may respond to psychological therapies or pharmacological treatments. Second, AAS suppress the male hypothalamic-pituitary-gonadal axis via their androgenic effects, potentially causing hypogonadism during AAS withdrawal. Men experiencing prolonged dysphoric effects or frank major depression from hypogonadism may desire to resume AAS, thus contributing to AAS dependence. AAS-induced hypogonadism may require treatment with human chorionic gonadotropin or clomiphene to reactivate neuroendocrine function, and may necessitate antidepressant treatments in cases of depression inadequately responsive to endocrine therapies alone. Third, human and animal evidence indicates that AAS also possess hedonic effects, which likely promote dependence via mechanisms shared with classical addictive drugs, especially opioids. Indeed, the opioid antagonist naltrexone blocks AAS dependence in animals. By inference, pharmacological and psychosocial treatments for human opioid dependence might also benefit AAS-dependent individuals. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  1. THE APPLICATION OF EVIDENCE BASED DESIGN IN EMERGENCY ROOM OF PUBLIC HOSPITAL OF DR. R. SOSODORO DJATIKOESOEMO BOJONEGORO

    Directory of Open Access Journals (Sweden)

    Noerkayatin ,

    2015-07-01

    Full Text Available The Hospital facilities built under Evidence Based Design (EBD will create a safe and comfortable environment, lower the nosocomial infection, quicken the patient recovery, lower the treatment cost, and improve staffs’ performance. The emergency room of public hospital of Dr.R.Sosodoro Djatikoesoemo Bojonegoro needs to be redesigned because the existing design does not meet physical safety. The reparation should refer to Facilities and Safety Management (FMS, Indonesian regulation, EBD concept and benchmarking to RSCM Jakarta considered as an application sample. This research applies case study with descriptive single case study design. The result of the research shows that reparation should be done that includes site and location, building components, and rooms lay out. The width of the rooms should meet minimal standard. The placing of triage room and resuscitation should be in the front area. Sinks should be located near the entrance of every room. The isolation and decontamination rooms should be provided.

  2. Poorly understood and often miscategorized congenital umbilical cord hernia: an alternative repair method.

    Science.gov (United States)

    İnce, E; Temiz, A; Ezer, S S; Gezer, H Ö; Hiçsönmez, A

    2017-06-01

    Umbilical cord hernia is poorly understood and often miscategorized as "omphalocele minor". Careless clamping of the cord leads to iatrogenic gut injury in the situation of umbilical cord hernia. This study aimed to determine the characteristics and outcomes of umbilical cord hernias. We also highlight an alternative repair method for umbilical cord hernias. We recorded 15 cases of umbilical cord hernias over 10 years. The patients' data were retrospectively reviewed, and preoperative preparation of the newborn, gestational age, birth weight, other associated malformations, surgical technique used, enteral nutrition, and length of hospitalization were recorded. This study included 15 neonates with umbilical cord hernias. The mean gestational age at the time of referral was 38.2 ± 2.1

  3. The market of human organs: a window into a poorly understood global business.

    Science.gov (United States)

    Surman, O S; Saidi, R; Purtilo, R; Simmerling, M; Ko, D; Burke, T F

    2008-03-01

    The global demand for human organs has set the stage for an exploding and poorly understood global business in human organs. Whenever there is demand for a product, the opportunity for business arises. The form that a business takes is dependent on a complex network of inputs and outputs, each affecting the others. Historically, the details of any specific market are drastically underestimated. Nowhere is this truer than in the market of human organs. The drivers, which propel the "goods" of human organs, form a flourishing business. Critical analysis is essential to understanding of the supply and demand sides and to determine the role of government in regulating the industry. Governmental groups have dismissed formation of a regulated market for organ sales. The concept is nonetheless a topic of active discussion, motivated by the suffering of patients in need of organs and exploitation of the victims of human trafficking. Ethical principles have been invoked on each side of the ensuing debate. Theory in the absence of sufficient data is shaky ground for enactment of new policy. The Aristotelian concept of "practical wisdom" and the pragmatism of William James illuminate the importance of scientific investigation as guide to policy formation. How will stakeholders benefit or lose? What impact might be anticipated in regard to organized medicine's social contract? What can we learn about cross-cultural differences and their effect on the global landscape?

  4. Small vessel disease, neurovascular regulation and cognitive impairment: post-mortem studies reveal a complex relationship, still poorly understood.

    Science.gov (United States)

    Love, Seth; Miners, J Scott

    2017-07-15

    The contribution of vascular disease to cognitive impairment is under-recognized and the pathogenesis is poorly understood. This information gap has multiple causes, including a lack of post-mortem validation of clinical diagnoses of vascular cognitive impairment (VCI) or vascular dementia (VaD), the exclusion of cases with concomitant neurodegenerative disease when diagnosing VCI/VaD, and a lack of standardization of neuropathological assessment protocols for vascular disease. Other contributors include a focus on end-stage destructive lesions to the exclusion of more subtle types of diffuse brain injury, on structural abnormalities of arteries and arterioles to the exclusion of non-structural abnormalities and capillary damage, and the use of post-mortem sampling strategies that are biased towards the identification of neurodegenerative pathologies. Recent studies have demonstrated the value of detailed neuropathology in characterizing vascular contributions to cognitive impairment (e.g. in diabetes), and highlight the importance of diffuse white matter changes, capillary damage and vasoregulatory abnormalities in VCI/VaD. The use of standardized, evidence-based post-mortem assessment protocols and the inclusion of biochemical as well as morphological methods in neuropathological studies should improve the accuracy of determination of the contribution of vascular disease to cognitive impairment and clarify the relative contribution of different pathogenic processes to the tissue damage. © 2017 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society.

  5. The rationale for use of Ulipristal Acetate as first line in emergency contraception: biological and clinical evidence.

    Science.gov (United States)

    Glasier, Anna

    2014-10-01

    Ulipristal acetate (UPA) was licensed as an emergency contraceptive (EC) in Europe in 2009. By the end of May 2013, over 1.4 million courses had been used. The rationale for using UPA for EC in favor of the much more commonly used levonorgestrel (LNG) is based on data on efficacy, safety and side effects. In two large clinical trials among women presenting for EC up to 120 hours after unprotected sex, UPA was as effective as LNG at preventing pregnancy. When the two trials were combined in a meta analysis UPA was superior, almost halving the risk of pregnancy compared with LNG. Biomedical studies have shown that UPA inhibits or delays ovulation more effectively than LNG at a stage of the cycle when the risk of pregnancy is highest. Safety and side effects: UPA and LNG have similar side effect profiles and to date no serious adverse events have been attributed to use of UPA for EC. Data on pregnancies conceived in association with UPA use are reassuring. There is no evidence for teratogenesis or for any increased risk of ectopic pregnancy or miscarriage. Use of UPA will remain limited until it is available without a doctor's prescription.

  6. A prospective multiple case study of the impact of emerging scientific evidence on established colorectal cancer screening programs: a study protocol.

    Science.gov (United States)

    Geddie, Hannah; Dobrow, Mark J; Hoch, Jeffrey S; Rabeneck, Linda

    2012-06-01

    Health-policy decision making is a complex and dynamic process, for which strong evidentiary support is required. This includes scientifically produced research, as well as information that relates to the context in which the decision takes place. Unlike scientific evidence, this "contextual evidence" is highly variable and often includes information that is not scientifically produced, drawn from sources such as political judgement, program management experience and knowledge, or public values. As the policy decision-making process is variable and difficult to evaluate, it is often unclear how this heterogeneous evidence is identified and incorporated into "evidence-based policy" decisions. Population-based colorectal cancer screening poses an ideal context in which to examine these issues. In Canada, colorectal cancer screening programs have been established in several provinces over the past five years, based on the fecal occult blood test (FOBT) or the fecal immunochemical test. However, as these programs develop, new scientific evidence for screening continues to emerge. Recently published randomized controlled trials suggest that the use of flexible sigmoidoscopy for population-based screening may pose a greater reduction in mortality than the FOBT. This raises the important question of how policy makers will address this evidence, given that screening programs are being established or are already in place. This study will examine these issues prospectively and will focus on how policy makers monitor emerging scientific evidence and how both scientific and contextual evidence are identified and applied for decisions about health system improvement. This study will employ a prospective multiple case study design, involving participants from Ontario, Alberta, Manitoba, Nova Scotia, and Quebec. In each province, data will be collected via document analysis and key informant interviews. Documents will include policy briefs, reports, meeting minutes, media

  7. Neoliberal policies and urban reconfigurations. Victoria, San Fernando, province of Buenos Aires, a city understood from theory

    Directory of Open Access Journals (Sweden)

    Laura Ester Donadío

    2016-07-01

    Full Text Available This article aims to explain from a theoretical conceptual approach the particularities that exist in Victoria, San Fernando, Buenos Aires, from its urban production. Through a series of field works, semi-structured interviews and observations, it was possible to perceive that in this locality, there are three logics of city production, market, state and necessity, according to Abramo, P. (2002. The post-development cities of Latin America, a space in which constant tensions are generated that alter the harmonious development of daily life and the interaction of those who inhabit the area. On the other hand, it is also perceived that the inhabitants naturalize that way of life, their spatial disposition, the progressive privatization of public areas and the proliferation of closed housing estates. Here is a quote that we have heard repeatedly in interviews with the neighbors: "No one in Victoria gives a ball to anyone." At the moment of understanding Victoria from the theory, we take into account such concepts as the "heterotopy" of Foucault M. (1967 - understood as the juxtaposition of spaces that would be incompatible -the term "com-fusa city" (Abramo P. - as an urban structure that interweaves two traditional models (the Mediterranean compact and the Anglo-Saxon diffused, the notion of "privatopia" by I.Rodriguez Chumillas (2005 and E. Mckenzie (1994 as private spatial consolidation, and finally the concepts: informative and dual cities of R Castells (1995 terms that emerge from the process of globalization, which may be useful to think about the reality of Victoria .

  8. Vitamin D Status and the Host Resistance to Infections: What It Is Currently (Not) Understood.

    Science.gov (United States)

    Lang, Pierre Olivier; Aspinall, Richard

    2017-05-01

    Vitamin D is increasingly thought to play a role in regulating immunity. This comprehensive review updates the current understanding regarding ways in which we believe that vitamin D regulates responsiveness of the immune system and how serum status modulates the host defense against pathogens. The literature was searched by using PubMed and Scopus with the following key words: vitamin D, immunity, innate and adaptive immunity, infectious disease, and vaccine response. Vitamin D deficiency remains a major public health concern worldwide. The overall body of evidence confirms that vitamin D plays an important role in modulating the immune response to infections. Epidemiologic studies suggest a clear association between vitamin D deficiency and susceptibility to various pathogens. However, translation of vitamin D use into the clinic as a means of controlling infections is fraught with methodologic and epidemiologic challenges. The recent discovery of alternative activation pathways, different active forms of vitamin D, and possible interaction with non-vitamin D receptors provide further complications to an already complex interaction between vitamin D and the immune system. Moreover, it has become apparent that the individual responsiveness to supplementation is more dynamic than presumed from the static assessment of 25-hydroxy vitamin D status. Furthermore, the epigenetic response at the level of the individual to environmental changes and lifestyle or health conditions provides greater variation than those resulting from vitamin D receptor polymorphisms. To understand the future of vitamin D with respect to clinical applications in the prevention and better control of infectious diseases, it is necessary to determine all aspects of vitamin D metabolism, as well as the mechanisms by which active forms interact with the immune system globally. For the most part, we are unable to identify tissue-specific applications of supplementation except for those subjects at

  9. Reviewing the Purpose of Education and Challenges Faced in Implementing Sound Pedagogical Practices in the Presence of Emerging Evidence from Neuroscience

    Science.gov (United States)

    Watagodakumbura, Chandana

    2015-01-01

    The field of neuroscience has been evolving constantly and at a rapid pace in the recent past. Consequently, neuroscientists have put forth a wealth of knowledge in relation learning and education in general. In this context, how can we as educators benefit from the emerging evidence from neuroscience so that we can take a significant step forward…

  10. Educating Through Exploration: Emerging Evidence for Improved Learning Outcomes Using a New Theory of Digital Learning Design

    Science.gov (United States)

    Anbar, Ariel; Center for Education Through eXploration

    2018-01-01

    Advances in scientific visualization and public access to data have transformed science outreach and communication, but have yet to realize their potential impacts in the realm of education. Computer-based learning is a clear bridge between visualization and education that benefits students through adaptative personalization and enhanced access. Building this bridge requires close partnerships among scientists, technologists, and educators.The Infiniscope project fosters such partnerships to produce exploration-driven online learning experiences that teach basic science concepts using a combination of authentic space science narratives, data, and images, and a personalized guided inquiry approach. Infiniscope includes a web portal to host these digital learning experiences, as well as a teaching network of educators using and modifying these experiences. Infiniscope experiences are built around a new theory of digital learning design that we call “education through exploration” (ETX) developed during the creation of successful online, interactive science courses offered at ASU and other institutions. ETX builds on the research-based practices of active learning and guided inquiry to provide a set of design principles that aim to develop higher order thinking skills in addition to understanding of content. It is employed in these experiences by asking students to solve problems and actively discover relationships, supported by an intelligent tutoring system which provides immediate, personalized feedback and scaffolds scientific thinking and methods. The project is led by ASU’s School of Earth and Space Exploration working with learning designers in the Center for Education Through eXploration, with support from NASA’s Science Mission Directorate as part of the NASA Exploration Connection program.We will present an overview of ETX design, the Infinscope project, and emerging evidence of effectiveness.

  11. Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

    Directory of Open Access Journals (Sweden)

    Michael J. Stewart

    2013-02-01

    decline and handicap levels, and improving feelings of empowerment and satisfaction with care provided. The research also demonstrated benefits to the health system, including a more appropriate use of emergency rooms, and decreased consultations with medical specialists. Discussion: Reviewing the body of research reveals the importance of both designing programs with an eye to local context, and building in flexibility allowing the program to be adapted to changing circumstances.  Creating partnerships between policy designers, project implementers, and academic teams is an important element in achieving these goals. Partnerships are also valuable for achieving effective monitoring and evaluation, and support to "evidence-based" policy-making processes. Despite a shared electronic health record being a key component of the service model, there was an under-investigation of the impact this technology on facilitating and enabling integration and the outcomes achieved. Conclusions: PRISMA provides evidence of the benefits that can arise from integrating care for older persons, particularly in terms of increased feelings of personal empowerment, and improved client satisfaction with the care provided. Taken alongside other integrated care experiments, PRISMA provides further evidentiary support to policy makers pursuing integrated care programs. The scale and scope of the research body highlights the long-term and complex nature of program evaluations, but underscores the benefits of evaluation, review and subsequent adaptation of programs. The role of information technology in supporting integration of services is likely to substantially expand in the future and the potential this technology offers should be investigated and harnessed. Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including

  12. Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

    Directory of Open Access Journals (Sweden)

    Michael J. Stewart

    2013-02-01

    decline and handicap levels, and improving feelings of empowerment and satisfaction with care provided. The research also demonstrated benefits to the health system, including a more appropriate use of emergency rooms, and decreased consultations with medical specialists.Discussion: Reviewing the body of research reveals the importance of both designing programs with an eye to local context, and building in flexibility allowing the program to be adapted to changing circumstances.  Creating partnerships between policy designers, project implementers, and academic teams is an important element in achieving these goals. Partnerships are also valuable for achieving effective monitoring and evaluation, and support to "evidence-based" policy-making processes. Despite a shared electronic health record being a key component of the service model, there was an under-investigation of the impact this technology on facilitating and enabling integration and the outcomes achieved.Conclusions: PRISMA provides evidence of the benefits that can arise from integrating care for older persons, particularly in terms of increased feelings of personal empowerment, and improved client satisfaction with the care provided. Taken alongside other integrated care experiments, PRISMA provides further evidentiary support to policy makers pursuing integrated care programs. The scale and scope of the research body highlights the long-term and complex nature of program evaluations, but underscores the benefits of evaluation, review and subsequent adaptation of programs. The role of information technology in supporting integration of services is likely to substantially expand in the future and the potential this technology offers should be investigated and harnessed. Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including

  13. BET 2: Poor evidence on whether teaching cognitive debiasing, or cognitive forcing strategies, lead to a reduction in errors attributable to cognition in emergency medicine students or doctors.

    Science.gov (United States)

    Oliver, Govind; Oliver, Gopal; Body, Rick

    2017-08-01

    A short review was carried out to see if teaching cognitive forcing strategies reduces cognitive error in the practice of emergency medicine. Two relevant papers were found using the described search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. There is currently little evidence that teaching cognitive forcing strategies reduces cognitive error in the practice of emergency medicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Does Gender Moderate the Relations Between Externalizing Behavior and Key Emergent Literacy Abilities? Evidence From a Longitudinal Study.

    Science.gov (United States)

    Allan, Nicholas P; Joye, Shauna W; Lonigan, Christopher J

    2017-05-01

    There is a significant negative relation between externalizing behavior and emergent literacy skills among preschool children. The purpose of this study was to examine the impact of gender on the predictive relation of externalizing behavior and emergent literacy in a group of 178 preschool children (mean age = 48.50 months, SD = 3.66; 48% boys). Externalizing behaviors predicted emergent literacy over time. Distinct patterns of predictive associations dependent on gender were found. Girls with higher levels of externalizing behaviors experienced less change in their vocabulary skills compared with the vocabulary change shown by girls with lower levels of these problem behaviors. The results suggest that early identification programs that include externalizing behavior problems and their relation with emergent literacy development should account for potential gender differences. A theoretical framework in which girls with behavior problems receive less opportunity for vocabulary acquisition is presented.

  15. The formation of boards of directors as a contingent response to environmental uncertainty – Evidence from emerging economies

    Directory of Open Access Journals (Sweden)

    John Rice

    2008-11-01

    Full Text Available This paper provides some strong support for existing literature in an under-researched context (the emerging economies of the former Soviet Union and Central and Eastern Europe. We develop and apply a model linking Board formation and environmental uncertainty, finding some partial support for our anticipated relationships in the area of Board establishment and perceived financial sector uncertainly, although no support for our anticipated relationship between governmental sector uncertainty and Board formation. research is supportive of the broad assertion that strategy in emerging economies is different and a ‘one size fits all’ (generally American approach to the questions we ask regarding strategy in emerging regions will rarely provide accurate insights for management academics and practitioners with an interest in understanding and improving management decisions in the context of emerging economies

  16. An analysis of the macroeconomic conditions required for SME lending: Evidence from Turkey and other emerging market countries

    OpenAIRE

    Jenkins Hatice; Hossain Monir

    2017-01-01

    Providing small and medium enterprises (SMEs) with access to external finance has been a major concern for many governments and international organizations for three decades. In recent years the experiences of emerging market countries suggest that a paradigm shift is taking place in SME finance. Particularly in fast-growing emerging market countries such as Turkey, banks are increasingly targeting SMEs as a new line of banking business. This research analy...

  17. Identifying an evidence-based model of therapy for the pre-hospital emergency management of supraventricular tachycardia

    OpenAIRE

    Smith, Gavin

    2017-01-01

    This thesis provides a comprehensive reporting of the work undertaken to identify evidence supporting pre-hospital management of supraventricular tachycardia (SVT), delivering an evidence base for paramedic treatment of these patients. The literature search identified absences in evidence supporting therapies used within existing clinical guidelines. The vagal manoeuvres, the simplest and least invasive therapy to employ in the stable patient, were insufficiently evidenced regarding technique...

  18. Intra- and Inter-Regional Return and Volatility Spillovers Across Emerging and Developing Markets: Evidence from Stock Indices and Stock Index Futures

    OpenAIRE

    Yarovaya, Larisa; Brzeszczynski, Janusz; Lau, Marco Chi Keung

    2016-01-01

    We provide empirical evidence on the patterns of intra- and inter-regional transmission of information across 10 developed and 11 emerging markets in Asia, the Americas, Europe and Africa using both stock indices and stock index futures. The main transmission channels are examined in the period from 2005 to 2014 through the analysis of return and volatility spillovers around the most recent crises based on the generalized vector autoregressive framework. Our findings demonstrate that markets ...

  19. A review on prevention and treatment of post-orthodontic white spot lesions - evidence-based methods and emerging technologies

    DEFF Research Database (Denmark)

    Bergstrand, Fredrik; Twetman, Svante

    2011-01-01

    The aim of this paper was to update the evidence for primary and secondary prevention (treatment) of white spot lesions (WSL) adjacent to fixed orthodontic appliances.......The aim of this paper was to update the evidence for primary and secondary prevention (treatment) of white spot lesions (WSL) adjacent to fixed orthodontic appliances....

  20. An analysis of the macroeconomic conditions required for SME lending: Evidence from Turkey and other emerging market countries

    Directory of Open Access Journals (Sweden)

    Jenkins Hatice

    2017-01-01

    Full Text Available Providing small and medium enterprises (SMEs with access to external finance has been a major concern for many governments and international organizations for three decades. In recent years the experiences of emerging market countries suggest that a paradigm shift is taking place in SME finance. Particularly in fast-growing emerging market countries such as Turkey, banks are increasingly targeting SMEs as a new line of banking business. This research analyzes how macroeconomic factors have contributed to increased commercial bank lending to SMEs in six emerging market countries: Turkey, Argentina, Brazil, Mexico, Chile, and Poland. Based on time series and panel data analysis, we find that a high GDP growth rate and increased competition in the banking sector have contributed to increased banking sector credit to SMEs. The findings also reveal that curbing the high inflation rate and reducing government domestic borrowing have significantly encouraged bank lending to the SME segment.

  1. Reducing rural maternal mortality and the equity gap in northern Nigeria: the public health evidence for the Community Communication Emergency Referral strategy

    Directory of Open Access Journals (Sweden)

    Aradeon SB

    2016-03-01

    Full Text Available Susan B Aradeon,1 Henry V Doctor2 1Freelance International Consultant (Social and Behavioral Change Communication, Aventura, FL, USA; 2Department of Information, Evidence and Research, Regional Office for the Eastern Mediterranean, World Health Organization, Nasr City, Cairo, Egypt Abstract: The Sustainable Development Goal (SDG maternal mortality target risks being underachieved like its Millennium Development Goal (MDG predecessor. The MDG skilled birth attendant (SBA strategy proved inadequate to end preventable maternal deaths for the millions of rural women living in resource-constrained settings. This equity gap has been successfully addressed by integrating a community-based emergency obstetric care strategy into the intrapartum care SBA delivery strategy in a large scale, northern Nigerian health systems strengthening project. The Community Communication Emergency Referral (CCER strategy catalyzes community capacity for timely evacuations to emergency obstetric care facilities instead of promoting SBA deliveries in environments where SBA availability and accessibility will remain inadequate for the near and medium term. Community Communication is an innovative, efficient, equitable, and culturally appropriate community mobilization approach that empowers low- and nonliterate community members to become the communicators. For the CCER strategy, this community mobilization approach was used to establish and maintain emergency maternal care support structures. Public health evidence demonstrates the success of integrating the CCER strategy into the SBA strategy and the practicability of this combined strategy at scale. In intervention sites, the maternal mortality ratio reduced by 16.8% from extremely high levels within 4 years. Significantly, the CCER strategy contributed to saving one-third of the lives saved in the project sites, thereby maximizing the effectiveness of the SBAs and upgraded emergency obstetric care facilities. Pre- and

  2. [Analysis of the knowledge and practices of health care workers in Emergency Departments regarding the protection and preservation of evidence in forensic cases].

    Science.gov (United States)

    Ilçe, Arzu; Yıldız, Dilek; Baysal, Gonca; Ozdoğan, Fatma; Taş, Fatma

    2010-11-01

    The frequency of violent incidents is increasing. This increase has made the role of Emergency Department (ED) staff more important in the collection, recording, protection, and storage of the evidence until the arrival of the responsible people concerned with the issue. Therefore, this study was designed to analyze the knowledge and practices of the nursing staff working in the EDs with respect to the protection and preservation of the evidence in forensic cases. This research, which was designed to be descriptive, was conducted with 44 health care workers in the hospitals with Emergency Departments in the center of Bolu province between October 2008 and January 2009. It was observed that 90.9% of the health care workers encountered forensic cases, 65.9% of them had not attended any training on forensic cases, and 22.7% of them did not use care when removing and storing the clothes of the patient. It was considered that 90.9% of the health care workers duly carry out their duties and responsibilities in forensic cases; however, 18.2% of them do not have sufficient knowledge or practical experience in the preservation and protection of evidence in forensic cases. It was observed that most health care workers do not have sufficient knowledge or practical experience in the preservation and protection of evidence in forensic cases.

  3. Can yeast glycolysis be understood in terms of in vitro kinetics of the constituent enxymes? Testing biochemistry.

    NARCIS (Netherlands)

    Teusink, B.; Passarge, J.R.; Reijenga, C.A.; Esgalhado, M.E.L.M.; van der Weijden, C.C.; Schepper, M.; Walsh, M.C.; Bakker, B.M.; van Dam, K.; Westerhoff, H.V.; Snoep, J.L.

    2000-01-01

    This paper examines whether the in vivo behavior of yeast glycolysis can be understood in terms of the in vitro kinetic properties of the constituent enzymes. In nongrowing, anaerobic, compressed Saccharomyces cerevisiae the values of the kinetic parameters of most glycolytic enzymes were

  4. Evidence for the Convergence Model: The Emergence of Highly Pathogenic Avian Influenza (H5N1 in Viet Nam.

    Directory of Open Access Journals (Sweden)

    Sumeet Saksena

    Full Text Available Building on a series of ground breaking reviews that first defined and drew attention to emerging infectious diseases (EID, the 'convergence model' was proposed to explain the multifactorial causality of disease emergence. The model broadly hypothesizes disease emergence is driven by the co-incidence of genetic, physical environmental, ecological, and social factors. We developed and tested a model of the emergence of highly pathogenic avian influenza (HPAI H5N1 based on suspected convergence factors that are mainly associated with land-use change. Building on previous geospatial statistical studies that identified natural and human risk factors associated with urbanization, we added new factors to test whether causal mechanisms and pathogenic landscapes could be more specifically identified. Our findings suggest that urbanization spatially combines risk factors to produce particular types of peri-urban landscapes with significantly higher HPAI H5N1 emergence risk. The work highlights that peri-urban areas of Viet Nam have higher levels of chicken densities, duck and geese flock size diversities, and fraction of land under rice or aquaculture than rural and urban areas. We also found that land-use diversity, a surrogate measure for potential mixing of host populations and other factors that likely influence viral transmission, significantly improves the model's predictability. Similarly, landscapes where intensive and extensive forms of poultry production overlap were found at greater risk. These results support the convergence hypothesis in general and demonstrate the potential to improve EID prevention and control by combing geospatial monitoring of these factors along with pathogen surveillance programs.

  5. THE RELATIONSHIP BETWEEN DIVERSIFICATION STRATEGY AND FIRM PERFORMANCE IN DEVELOPED AND EMERGING ECONOMY CONTEXTS: EVIDENCE FROM TURKEY, ITALY AND NETHERLANDS

    Directory of Open Access Journals (Sweden)

    Onur Akpinar

    2016-09-01

    Full Text Available The aim of this study is to determine whether there is a difference between types of diversification and performance comparing Turkey, Italy and Netherlands. There are studies with the conclusion that the indicators of the relationship between diversification strategies and firm performance of developed countries differ from the indicators of developing countries. The data of 166 firms in Netherlands, 265 firms in Italy and 128 firms in Turkey were analyzed. The data of 2007-2011 was used in the research. Return on Assets (ROA and Return on Sales (ROS for financial performance and Entropy Index for diversification were used. According to the results, there is no correlation between total entropy and a performance criterion ROA and ROS in Italy and Netherlands. On the other hand, in Turkey, it is understood that there is a low-level positive correlation between total entropy and firm performance.

  6. The impact of evidence-based sepsis guidelines on emergency department clinical practice: a pre-post medical record audit.

    Science.gov (United States)

    Romero, Bernadine; Fry, Margaret; Roche, Michael

    2017-11-01

    To explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, emergency department management and time to antibiotics. Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis. To improve patient outcomes, the New South Wales government in Australia introduced sepsis guidelines into emergency departments. However, the impact of the guidelines on clinical practice remains unclear. A 12-month pre-post retrospective randomised medical record audit of adult patients with a sepsis diagnosis. Data were extracted from the emergency department database and paper medical record. Data included patient demographic (age, gender), clinical information (time of arrival, triage code, seen by time, disposition, time to antibiotic, pathology, time to intravenous fluids) and patient assessment data (heart rate, respiratory rate, blood pressure, temperature, oxygen saturations, medication). This study demonstrated a statistically significant 230-minute reduction in time to antibiotics post implementation of the guidelines. The post group (n = 165) received more urgent triage categories (n = 81; 49·1%), a 758-minute reduction in mean time to second litre of intravenous fluids and an improvement in collection of lactate (n = 112, 67·9%), also statistically significant. The findings highlight the impact the guidelines can have on clinician decision-making and behaviour that support best practice and positive patient outcomes. The sepsis guidelines improved the early assessment, recognition and management of patients presenting with sepsis in one tertiary referral emergency department. The use of evidenced-based guidelines can impact clinical decision-making and behaviour, resulting in the translation and support of

  7. Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework.

    Science.gov (United States)

    Gushulak, Bd; Weekers, J; Macpherson, Dw

    2009-01-01

    International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced

  8. The emergency room at the Rotunda Hospital: evidence of an improving service over the past 3 years.

    LENUS (Irish Health Repository)

    Talukdar, S

    2014-12-01

    This is a retrospective review of the Rotunda Hospital Emergency Room (ER) documentation with respect to attendances for a 4-month period (August-November) in both 2009 and 2012. The aim was to quantify the workload and assess the quality of care offered to patients attending the ER over the two time periods and to highlight any improvements in care after changes were implemented following the initial 2009 review.

  9. Is restlessness best understood as a process? Reflecting on four boys’ restlessness during music therapy in kindergarten

    Science.gov (United States)

    Helle-Valle, Anna; Binder, Per-Einar; Anderssen, Norman; Stige, Brynjulf

    2017-01-01

    ABSTRACT ADHD can be considered an internationally recognized framework for understanding children’s restlessness. In this context, children’s restlessness is understood as a symptom of neurodevelopmental disorder. However, there are other possible understandings of children’s restlessness. In this article, we explore four boys’ collaborative and creative process as it is described and understood by three adults. The process is framed by a community music therapy project in a Norwegian kindergarten, and we describe four interrelated phases of this process: Exploring musical vitality and cooperation, Consolidating positions, Performing together, and Discovering ripple effects. We discuss these results in relation to seven qualities central to a community music therapy approach: participation, resource orientation, ecology, performance, activism, reflexivity and ethics. We argue that in contrast to a diagnostic approach that entails a focus on individual problems, a community music therapy approach can shed light on adult and systemic contributions to children’s restlessness. PMID:28532331

  10. Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 3: Toe fractures in adults.

    Science.gov (United States)

    Paradise, David

    2012-11-01

    A short cut review was carried out to establish whether intervention and follow up of patients with toe phalanx fractures is better than no treatment at reducing time to return to normal activity and need for surgical intervention. 40 papers were found using the reported searches, of which 1 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper is tabulated. It is concluded that there is no evidence to determine whether intervention of any type improves outcome in toe phalanx fractures.

  11. Safety - a Neglected Issue When Introducing Solid Biomass Fuel in Thermal Power Plants? Some Evidence of an Emerging Risk

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess; Astad, John

    2013-01-01

    The paper examines recent evidence from Denmark and abroad with climate change projects that aim to reduce global carbon dioxide emissions by converting coal fired thermal power plants to solid biomass fuel. The paper argues that projects appear to be pursued narrow-mindedly with insufficient att...

  12. An Origin of Life in Cycling Hot Spring Pools: Emerging Evidence from Chemistry, Geology and Computational Studies

    Science.gov (United States)

    Deamer, D. W.; Damer, B. F.; Van Kranendonk, M. J.; Djokic, T.

    2017-07-01

    New evidence for an origin of life in a hot spring setting on land is supported by three studies: chemical (polymerization in wet-dry cycles), geological (stromatolites in a 3.48 Ga geothermal field) and computational (verifying the kinetic trap).

  13. Is monetary policy really neutral in the long-run? Evidence for some emerging and developed economies

    OpenAIRE

    Reginaldo Pinto Nogueira

    2009-01-01

    The traditional economic theory suggests that changes in the money supply or in the interest rates can influence the business cycle, but not the long-run potential output. In other words, monetary policy is neutral over the long-run. In this paper we use some new developments in econometrics to test for the existence of a long-run relationship between the monetary policy instrument used by most Central Banks - short-term interest rates - and real output. Using annual data for 14 emerging and ...

  14. A Risk Metric Assessment of Scenario-Based Market Risk Measures for Volatility and Risk Estimation: Evidence from Emerging Markets

    Directory of Open Access Journals (Sweden)

    Sitima Innocent

    2015-03-01

    Full Text Available The study evaluated the sensitivity of the Value- at- Risk (VaR and Expected Shortfalls (ES with respect to portfolio allocation in emerging markets with an index portfolio of a developed market. This study utilised different models for VaR and ES techniques using various scenario-based models such as Covariance Methods, Historical Simulation and the GARCH (1, 1 for the predictive ability of these models in both relatively stable market conditions and extreme market conditions. The results showed that Expected Shortfall has less risk tolerance than VaR based on the same scenario-based market risk measures

  15. Analysing the long-run relationship among oil market, nuclear energy consumption, and economic growth: An evidence from emerging economies

    International Nuclear Information System (INIS)

    Naser, Hanan

    2015-01-01

    The primary objectives of this paper is to scrutinize the long-run relationship and the causal linkage between oil consumption, nuclear energy consumption, oil prices and economic growth. For this purpose, Johansen cointegration technique is applied using time series data for four emerging economies: Russia, China, South Korea and India, over the period from 1965 to 2010. Johansen cointegration results indicate that there is a long-run relationship between the proposed variables in each country. Exclusion tests show that both energy sources enter the cointegration space significantly (except for Russia), which suggests that energy has a long-run impact on economic growth. Results of the causal linkage between the variables point that energy consumption (i.e., oil or nuclear) has either a predictive power for economic growth, or a feedback impact between with real Gross Domestic Product (GDP) growth in all countries. Hence, energy conservation policies might harmful negative consequences on the growth of economic for this group of countries. - Highlights: • There is a long-run relationship among oil market, nuclear energy consumption, and economic growth. • Countries are energy dependent in stimulating economic growth. • There is feedback impact between oil consumption and economic growth in three out of four countries. • An increase in oil prices has drawbacks on emerging economies growth

  16. Evidence of children's vulnerability to radiation in the context of radiological/nuclear events and considerations for emergency response.

    Science.gov (United States)

    Lane, Rachel; Reinhardt, Pascale; Thompson, Patsy

    2010-11-01

    International organisations, such as International Atomic Energy Agency, United Nations Scientific Committee on the Effects of Atomic Radiation and World Health Organisation, together with committees of experts such as Biological Effects of Ionising Radiation and Committee on Medical Aspects of Radiation in the Environment, have assessed the effects of radiation on large exposed populations (Chernobyl accident, and Hiroshima/Nagasaki atomic bombings) and on nuclear energy workers and people living near nuclear facilities. Childhood and in utero exposure to moderate and high levels of ionizing radiation, such as those experienced during the atomic bombings of Japan, or from radiotherapy, is an established cause of leukaemia and solid cancer. There is no evidence of increase in solid cancers (excluding thyroid cancer) or leukaemia in the children from Chernobyl, and no evident link between worker's exposure to radiation and leukaemia in their offspring or with the presence of leukaemia clusters around nuclear power plants. It has also not been possible to demonstrate the evidence of radiation hereditary effects in human populations. In accordance with international guidance, Canadian Nuclear Safety Commission recommends optimisation of protection strategies to reduce doses to children. The development of credible radiological/nuclear event scenarios would assist in identifying probable sources of radioactivity and pathways of exposure for children. Such scenarios should then be used to identify protection strategies appropriate for children.

  17. Use of Banking Services in Emerging Markets -Household-Level Evidence (Replaces EBC DP 2010-025)

    OpenAIRE

    Beck, T.H.L.; Brown, M.

    2011-01-01

    This paper uses survey data for 60,000 households from 29 transition economies in 2006 and 2010 to explore how the use of banking services is related to household characteristics, as well as to bank ownership, deposit insurance and creditor protection. At the household level we find that the holding of a bank account, a bank card, or a mortgage increases with income and education in most countries and find evidence for an urban-rural gap. The use of banking services is also related to the rel...

  18. Use of Banking Services in Emerging Markets -Household-Level Evidence (Replaces CentER DP 2010-092)

    OpenAIRE

    Beck, T.H.L.; Brown, M.

    2011-01-01

    This paper uses survey data for 60,000 households from 29 transition economies in 2006 and 2010 to explore how the use of banking services is related to household characteristics, as well as to bank ownership, deposit insurance and creditor protection. At the household level we find that the holding of a bank account, a bank card, or a mortgage increases with income and education in most countries and find evidence for an urban-rural gap. The use of banking services is also related to the rel...

  19. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4: Hydrotherapy following rotator cuff repair.

    Science.gov (United States)

    Hay, Laura; Wylie, Katherine

    2011-07-01

    A short cut review was carried out to establish whether hydrotherapy is beneficial in rehabilitation after rotator cuff repair. 27 papers were found using the reported searches, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of that best paper are tabulated. It is concluded that while there may be some short term benefit to passive range of movement, further research is needed.

  20. Testing the emergence of New Caledonia: fig wasp mutualism as a case study and a review of evidence.

    Directory of Open Access Journals (Sweden)

    Astrid Cruaud

    Full Text Available While geologists suggest that New Caledonian main island (Grande Terre was submerged until ca 37 Ma, biologists are struck by the presence of supposedly Gondwanan groups on the island. Among these groups are the Oreosycea fig trees (Ficus, Moraceae and their Dolichoris pollinators (Hymenoptera, Agaonidae. These partners are distributed in the Paleotropics and Australasia, suggesting that their presence on New Caledonia could result from Gondwanan vicariance. To test this hypothesis, we obtained mitochondrial and nuclear markers (5.3 kb from 28 species of Dolichoris, used all available sequences for Oreosycea, and conducted phylogenetic and dating analyses with several calibration strategies. All our analyses ruled out a vicariance scenario suggesting instead that New Caledonian colonization by Dolichoris and Oreosycea involved dispersal across islands from Sundaland ca 45.9-32.0 Ma. Our results show that successful long-distance dispersal of obligate mutualists may happen further suggesting that presence of intimate mutualisms on isolated islands should not be used as a priori evidence for vicariance. Comparing our results to a review of all the published age estimates for New Caledonian plant and animal taxa, we showed that support for a vicariant origin of the island biota is still lacking. Finally, as demonstrating a causal relationship between geology and biology requires independent evidence, we argue that a priori assumptions about vicariance or dispersal should not be used to constrain chronograms. This circular reasoning could lead to under or overestimation of age estimates.

  1. Does functional MRI detect activation in white matter? A review of emerging evidence, issues, and future directions

    Science.gov (United States)

    Gawryluk, Jodie R.; Mazerolle, Erin L.; D'Arcy, Ryan C. N.

    2014-01-01

    Functional magnetic resonance imaging (fMRI) is a non-invasive technique that allows for visualization of activated brain regions. Until recently, fMRI studies have focused on gray matter. There are two main reasons white matter fMRI remains controversial: (1) the blood oxygen level dependent (BOLD) fMRI signal depends on cerebral blood flow and volume, which are lower in white matter than gray matter and (2) fMRI signal has been associated with post-synaptic potentials (mainly localized in gray matter) as opposed to action potentials (the primary type of neural activity in white matter). Despite these observations, there is no direct evidence against measuring fMRI activation in white matter and reports of fMRI activation in white matter continue to increase. The questions underlying white matter fMRI activation are important. White matter fMRI activation has the potential to greatly expand the breadth of brain connectivity research, as well as improve the assessment and diagnosis of white matter and connectivity disorders. The current review provides an overview of the motivation to investigate white matter fMRI activation, as well as the published evidence of this phenomenon. We speculate on possible neurophysiologic bases of white matter fMRI signals, and discuss potential explanations for why reports of white matter fMRI activation are relatively scarce. We end with a discussion of future basic and clinical research directions in the study of white matter fMRI. PMID:25152709

  2. Neotropics provide insights into the emergence of New World monkeys: New dental evidence from the late Oligocene of Peruvian Amazonia.

    Science.gov (United States)

    Marivaux, Laurent; Adnet, Sylvain; Altamirano-Sierra, Ali J; Boivin, Myriam; Pujos, François; Ramdarshan, Anusha; Salas-Gismondi, Rodolfo; Tejada-Lara, Julia V; Antoine, Pierre-Olivier

    2016-08-01

    Recent field efforts in Peruvian Amazonia (Contamana area, Loreto Department) have resulted in the discovery of a late Oligocene (ca. 26.5 Ma; Chambira Formation) fossil primate-bearing locality (CTA-61). In this paper, we analyze the primate material consisting of two isolated upper molars, the peculiar morphology of which allows us to describe a new medium-sized platyrrhine monkey: Canaanimico amazonensis gen. et sp. nov. In addition to the recent discovery of Perupithecus ucayaliensis, a primitive anthropoid taxon of African affinities from the alleged latest Eocene Santa Rosa locality (Peruvian Amazonia), the discovery of Canaanimico adds to the evidence that primates were well-established in the Amazonian Basin during the Paleogene. Our phylogenetic results based on dental evidence show that none of the early Miocene Patagonian taxa (Homunculus, Carlocebus, Soriacebus, Mazzonicebus, Dolichocebus, Tremacebus, and Chilecebus), the late Oligocene Bolivian Branisella, or the Peruvian Canaanimico, is nested within a crown platyrrhine clade. All these early taxa are closely related and considered here as stem Platyrrhini. Canaanimico is nested within the Patagonian Soriacebinae, and closely related to Soriacebus, thereby extending back the soriacebine lineage to 26.5 Ma. Given the limited dental evidence, it is difficult to assess if Canaanimico was engaged in a form of pitheciine-like seed predation as is observed in Soriacebus and Mazzonicebus, but dental microwear patterns recorded on one upper molar indicate that Canaanimico was possibly a fruit and hard-object eater. If Panamacebus, a recently discovered stem cebine from the early Miocene of Panama, indicates that the crown platyrrhine radiation was already well underway by the earliest Miocene, Canaanimico indicates in turn that the "homunculid" radiation (as a part of the stem radiation) was well underway by the late Oligocene. These new data suggest that the stem radiation likely occurred in the Neotropics

  3. "Contagion" between the emerging and developed capital markets: empirical evidence and reflections on the international portfolio diversification

    Directory of Open Access Journals (Sweden)

    Wagner Moura Lamounier

    2008-10-01

    Full Text Available In this research, we analyzed the short and long term interdependence and relationship between the stock indices of the major emerging capital markets and the major developed markets for the period 1995-2005. The aim was to verify the existence and the dynamics of the “contagion” between the markets, or if the occurrence of crises and changes in the behavior of a market would have impacts on the behavior of the others. In the development of the work, we applied the methodology of the Vector Error Correction Model (VEC. We found the presence of cointegrating relationships between the markets analyzed, but was able to see that, despite being cointegrated markets, investors could benefit from international diversification of portfolios. That’s because the speed of adjustment of the long-term ratio of cointegration between the markets was low for the period analyzed. Accordingly, investors would have the opportunity to reduce risk by diversifying their portfolios.

  4. Gradual reforms and the emergence of energy market in China: Evidence from tests for convergence of energy prices

    International Nuclear Information System (INIS)

    Ma Hengyun; Oxley, Les; Gibson, John

    2009-01-01

    This study investigates the emergence of energy markets by testing for convergence of energy prices with a new dataset on energy spot prices in 35 major cities in China. Both descriptive statistics and unit root are employed to test the convergence of energy prices for each of four fuel price series. The whole study period is divided into two sub-periods in order to reconcile the gradual energy reforms. The results show the steady improvement in energy market performance in China, especially during the second sub-period, which suggests that the market appears to be playing an increasing role in determining energy prices. While panel unit root tests show energy markets are integrated in China as a whole, city-by-city univariate unit root tests suggest that there are still many regional energy markets, probably because energy reserves (especially coal) vary widely across regions. Since China's energy economy is gradually moving towards market-oriented mechanisms, the existing literature may become obsolete soon.

  5. Entrepreneurial University Perspective: Tracking Labor Force Capacity to Support Industrialization Processes in the Emerging Markets, Evidence from Kazakhstan Data

    Directory of Open Access Journals (Sweden)

    Dilara Orynbassarova

    2017-01-01

    Full Text Available Industrialisation is considered as main engine of growth in economic development of the most emerging markets. This is especially true for Central Asian transitional countries as Kazakhstan, which obtained independence from the Soviet Union in 1991. For enhancing country’s competitiveness potential, Kazakhstan National Program for 2010-2014 aimed to accelerate industrial-innovative development of the country. While many papers published about the importance of industrialization activities in Kazakhstan, few have focused on examining the current capacity of labor market to meet the industry demand. Main aim of this paper was to investigate if current manpower is adequate to maintain the planned rate of growth in the country. Higher level of economic production led to higher demand of engineering labor force. High demand with low frequency supply created an imbalance in the labor market that resulted what we see as shortage of technically skilled labor. Low frequency of supply is influenced by such factors as high engineers’ outflow rate, low students enrolment and graduation rates, and lack of practical skills of the graduates hired.

  6. Ultrafast terahertz spectroscopy study of a Kondo insulating thin-film Sm B6 : Evidence for an emergent surface state

    Science.gov (United States)

    Zhang, Jingdi; Yong, Jie; Takeuchi, Ichiro; Greene, Richard L.; Averitt, Richard D.

    2018-04-01

    We utilize terahertz time domain spectroscopy to investigate thin films of the heavy fermion compound Sm B6 , a prototype Kondo insulator. Temperature-dependent terahertz (THz) conductivity measurements reveal a rapid decrease in the Drude weight and carrier scattering rate at ˜T*=20 K , well below the hybridization gap onset temperature (100 K). Moreover, a low-temperature conductivity plateau (below 20 K) suggests the emergence of a surface state with an effective electron mass of 0.1 me . The conductivity dynamics following optical excitation is also measured and interpreted using Rothwarf-Taylor (R-T) phenomenology, yielding a hybridization gap energy of 17 meV. However, R-T modeling of the conductivity dynamics reveals a deviation from the expected thermally excited quasiparticle density at temperatures below 20 K, indicative of another channel opening up in the low-energy electrodynamics. Taken together, these results are consistent with the onset of a surface state well below the crossover temperature (100 K) after long-range coherence of the f -electron Kondo lattice is established.

  7. Interpreting the evidence: competing paradigms and the emergence of lesbian and gay suicide as a "social fact".

    Science.gov (United States)

    Erwin, K

    1993-01-01

    Almost two decades after the American Psychiatric Association acknowledged that homosexuality should no longer be considered a pathological condition, studies continue to show significantly higher rates of suicide, depression, substance abuse, and other indicators of psychological distress among lesbians and gay men than among heterosexuals in the United States. If homosexuality is not, in fact, pathological, then what accounts for such self-destructive behavior? This article examines contending causal theories of homosexual suicide and psychological distress ranging from religious and medical-psychiatric theories that problematize individual behavior to societal explanations that locate the cause in social intolerance and internalized oppression. Illuminating the origins of myths that persist today, it demonstrates how historical, social, and political forces have been instrumental in shaping the scientific and medical response to gay and lesbian psychological distress. Emphasis is on the need to question the "objective validity" of scientific theories in order to develop more effective responses to gay and lesbian mental health problems. Finally, this article considers alternative views of sexuality that are emerging from such sources as feminists and gay Native Americans, and proposes new directions for mental health research that encompass issues of diversity within the gay and lesbian population.

  8. Evolution and structure of Tomato spotted wilt virus populations: evidence of extensive reassortment and insights into emergence processes.

    Science.gov (United States)

    Tentchev, Diana; Verdin, Eric; Marchal, Cécile; Jacquet, Monique; Aguilar, Juan M; Moury, Benoît

    2011-04-01

    Tomato spotted wilt virus (TSWV; genus Tospovirus, family Bunyaviridae) genetic diversity was evaluated by sequencing parts of the three RNA genome segments of 224 isolates, mostly from pepper and tomato crops in southern Europe. Eighty-three per cent of the isolates showed consistent clustering into three clades, corresponding to their geographical origin, Spain, France or the USA, for the three RNA segments. In contrast, the remaining 17% of isolates did not belong to the same clade for the three RNA segments and were shown to be reassortants. Among them, eight different reassortment patterns were observed. Further phylogenetic analyses provided insights into the dynamic processes of the worldwide resurgence of TSWV that, since the 1980s, has followed the worldwide dispersal of the western flower thrips (Frankliniella occidentalis) tospovirus vector. For two clades composed essentially of Old World (OW) isolates, tree topology suggested a local re-emergence of indigenous TSWV populations following F. occidentalis introductions, while it could not be excluded that the ancestors of two other OW clades were introduced from North America contemporarily with F. occidentalis. Finally, estimation of the selection intensity that has affected the evolution of the NSs and nucleocapsid proteins encoded by RNA S of TSWV suggests that the former could be involved in the breakdown of resistance conferred by the Tsw gene in pepper.

  9. Can Nonurgent Emergency Department Care Costs be Reduced? Empirical Evidence from a U.S. Nationally Representative Sample.

    Science.gov (United States)

    Xin, Haichang; Kilgore, Meredith L; Sen, Bisakha Pia; Blackburn, Justin

    2015-09-01

    A well-functioning primary care system has the capacity to provide effective care for patients to avoid nonurgent emergency department (ED) use and related costs. This study examined how patients' perceived deficiency in ambulatory care is associated with nonurgent ED care costs nationwide. This retrospective cohort study used data from the 2010-2011 Medical Expenditure Panel Survey. This study chose usual source of care, convenience of needed medical care, and patient evaluation of care quality as the main independent variables. The marginal effect following a multivariate logit model was employed to analyze the urgent vs. nonurgent ED care costs in 2011, after controlling for covariates in 2010. The endogeneity was accounted for by the time lag effect and controlling for education levels. Sample weights and variance were adjusted with the survey procedures to make results nationally representative. Patient-perceived poor and intermediate levels of primary care quality had higher odds of nonurgent ED care costs (odds ratio [OR] = 2.22, p = 0.035, and OR = 2.05, p = 0.011, respectively) compared to high-quality care, with a marginal effect (at means) of 13.0% and 11.5% higher predicted probability of nonurgent ED care costs. Costs related to these ambulatory care quality deficiencies amounted to $229 million for private plans (95% confidence interval [CI] $100 million-$358 million), $58.5 million for public plans (95% CI $33.9 million-$83.1 million), and an overall of $379 million (95% CI $229 million-$529 million) nationally. These findings highlight the improvement in ambulatory care quality as the potential target area to effectively reduce nonurgent ED care costs. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Transcranial direct current stimulation in obsessive-compulsive disorder: emerging clinical evidence and considerations for optimal montage of electrodes.

    Science.gov (United States)

    Senço, Natasha M; Huang, Yu; D'Urso, Giordano; Parra, Lucas C; Bikson, Marom; Mantovani, Antonio; Shavitt, Roseli G; Hoexter, Marcelo Q; Miguel, Eurípedes C; Brunoni, André R

    2015-07-01

    Neuromodulation techniques for obsessive-compulsive disorder (OCD) treatment have expanded with greater understanding of the brain circuits involved. Transcranial direct current stimulation (tDCS) might be a potential new treatment for OCD, although the optimal montage is unclear. To perform a systematic review on meta-analyses of repetitive transcranianal magnetic stimulation (rTMS) and deep brain stimulation (DBS) trials for OCD, aiming to identify brain stimulation targets for future tDCS trials and to support the empirical evidence with computer head modeling analysis. Systematic reviews of rTMS and DBS trials on OCD in Pubmed/MEDLINE were searched. For the tDCS computational analysis, we employed head models with the goal of optimally targeting current delivery to structures of interest. Only three references matched our eligibility criteria. We simulated four different electrodes montages and analyzed current direction and intensity. Although DBS, rTMS and tDCS are not directly comparable and our theoretical model, based on DBS and rTMS targets, needs empirical validation, we found that the tDCS montage with the cathode over the pre-supplementary motor area and extra-cephalic anode seems to activate most of the areas related to OCD.

  11. Evidence for the emergence of new rice types of interspecific hybrid origin in West African farmers' fields.

    Directory of Open Access Journals (Sweden)

    Edwin Nuijten

    2009-10-01

    Full Text Available In West Africa two rice species (Oryza glaberrima Steud. and Oryza sativa L. co-exist. Although originally it was thought that interspecific hybridization is impossible without biotechnological methods, progenies of hybridization appear to occur in farmer fields. AFLP analysis was used to assess genetic diversity in West Africa (including the countries The Gambia, Senegal, Guinea Bissau, Guinea Conakry, Sierra Leone, Ghana and Togo using 315 rice samples morphologically classified prior to analysis. We show evidence for farmer interspecific hybrids of African and Asian rice, resulting in a group of novel genotypes, and identify possible mechanisms for in-field hybridization. Spontaneous back-crossing events play a crucial role, resulting in different groups of genetic diversity in different regions developed by natural and cultural selection, often under adverse conditions. These new groups of genotypes may have potential relevance for exploitation by plant breeders. Future advances in crop development could be achieved through co-operation between scientists and marginalized farmer groups in order to address challenges of rapid adaptation in a world of increasing socio-political and climatic uncertainty.

  12. Prenatal factors contribute to the emergence of kwashiorkor or marasmus in severe undernutrition: evidence for the predictive adaptation model.

    Directory of Open Access Journals (Sweden)

    Terrence E Forrester

    Full Text Available Severe acute malnutrition in childhood manifests as oedematous (kwashiorkor, marasmic kwashiorkor and non-oedematous (marasmus syndromes with very different prognoses. Kwashiorkor differs from marasmus in the patterns of protein, amino acid and lipid metabolism when patients are acutely ill as well as after rehabilitation to ideal weight for height. Metabolic patterns among marasmic patients define them as metabolically thrifty, while kwashiorkor patients function as metabolically profligate. Such differences might underlie syndromic presentation and prognosis. However, no fundamental explanation exists for these differences in metabolism, nor clinical pictures, given similar exposures to undernutrition. We hypothesized that different developmental trajectories underlie these clinical-metabolic phenotypes: if so this would be strong evidence in support of predictive adaptation model of developmental plasticity.We reviewed the records of all children admitted with severe acute malnutrition to the Tropical Metabolism Research Unit Ward of the University Hospital of the West Indies, Kingston, Jamaica during 1962-1992. We used Wellcome criteria to establish the diagnoses of kwashiorkor (n = 391, marasmus (n = 383, and marasmic-kwashiorkor (n = 375. We recorded participants' birth weights, as determined from maternal recall at the time of admission. Those who developed kwashiorkor had 333 g (95% confidence interval 217 to 449, p<0.001 higher mean birthweight than those who developed marasmus.These data are consistent with a model suggesting that plastic mechanisms operative in utero induce potential marasmics to develop with a metabolic physiology more able to adapt to postnatal undernutrition than those of higher birthweight. Given the different mortality risks of these different syndromes, this observation is supportive of the predictive adaptive response hypothesis and is the first empirical demonstration of the advantageous effects of such a

  13. The implementation and evaluation of an evidence-based statewide prehospital pain management protocol developed using the national prehospital evidence-based guideline model process for emergency medical services.

    Science.gov (United States)

    Brown, Kathleen M; Hirshon, Jon Mark; Alcorta, Richard; Weik, Tasmeen S; Lawner, Ben; Ho, Shiu; Wright, Joseph L

    2014-01-01

    In 2008, the National Highway Traffic Safety Administration funded the development of a model process for the development and implementation of evidence-based guidelines (EBGs) for emergency medical services (EMS). We report on the implementation and evaluation of an evidence-based prehospital pain management protocol developed using this model process. An evidence-based protocol for prehospital management of pain resulting from injuries and burns was reviewed by the Protocol Review Committee (PRC) of the Maryland Institute for Emergency Medical Services Systems (MIEMSS). The PRC recommended revisions to the Maryland protocol that reflected recommendations in the EBG: weight-based dosing and repeat dosing of morphine. A training curriculum was developed and implemented using Maryland's online Learning Management System and successfully accessed by 3,941 paramedics and 15,969 BLS providers. Field providers submitted electronic patient care reports to the MIEMSS statewide prehospital database. Inclusion criteria were injured or burned patients transported by Maryland ambulances to Maryland hospitals whose electronic patient care records included data for level of EMS provider training during a 12-month preimplementation period and a 12-month postimplementation period from September 2010 through March 2012. We compared the percentage of patients receiving pain scale assessments and morphine, as well as the dose of morphine administered and the use of naloxone as a rescue medication for opiate use, before and after the protocol change. No differences were seen in the percentage of patients who had a pain score documented or the percent of patients receiving morphine before and after the protocol change, but there was a significant increase in the total dose and dose in mg/kg administered per patient. During the postintervention phase, patients received an 18% higher total morphine dose and a 14.9% greater mg/kg dose. We demonstrated that the implementation of a revised

  14. Evidence of reassortment of pandemic H1N1 influenza virus in swine in Argentina: are we facing the expansion of potential epicenters of influenza emergence?

    Science.gov (United States)

    Pereda, Ariel; Rimondi, Agustina; Cappuccio, Javier; Sanguinetti, Ramon; Angel, Matthew; Ye, Jianqiang; Sutton, Troy; Dibárbora, Marina; Olivera, Valeria; Craig, Maria I.; Quiroga, Maria; Machuca, Mariana; Ferrero, Andrea; Perfumo, Carlos; Perez, Daniel R.

    2011-01-01

    Please cite this paper as: Pereda et al. (2011) Evidence of reassortment of pandemic H1N1 influenza virus in swine in Argentina: are we facing the expansion of potential epicenters of influenza emergence? Influenza and Other Respiratory Viruses 5(6), 409–412. In this report, we describe the occurrence of two novel swine influenza viruses (SIVs) in pigs in Argentina. These viruses are the result of two independent reassortment events between the H1N1 pandemic influenza virus (H1N1pdm) and human‐like SIVs, showing the constant evolution of influenza viruses at the human–swine interface and the potential health risk of H1N1pdm as it appears to be maintained in the swine population. It must be noted that because of the lack of information regarding the circulation of SIVs in South America, we cannot discard the possibility that ancestors of the H1N1pdm or other SIVs have been present in this part of the world. More importantly, these findings suggest an ever‐expanding geographic range of potential epicenters of influenza emergence with public health risks. PMID:21668680

  15. Surgeon-level reporting presented by funnel plot is understood by doctors but inaccurately interpreted by members of the public.

    Science.gov (United States)

    Bhalla, Ashish; Mehrotra, Prerna; Amawi, Falah; Lund, Jonathan N

    2015-01-01

    Risk-adjusted outcome data for general surgeons practicing in the United Kingdom were published for the first time in 2013 with the aim of increasing transparency, improving standards, and providing the public with information to aid decision making. Most specialties used funnel plots to present their data. We assess the ability of members of the public (MoP), medical students, nonsurgical doctors (NSD), and surgeons to understand risk-adjusted surgical outcome data. A fictitious outcome dataset was created and presented in the form of a funnel plot to 10 participants from each of the aforementioned group. Standard explanatory text was provided. Each participant was given 5 minutes to review the funnel plot and complete a questionnaire. For each question, there was only 1 correct answer. Completion rate was 100% (n = 40). No difference existed between NSD and surgeons. A significant difference for identification of the "worst performing surgeon" was noted between surgeons and MoP (p plot significantly "more difficult" to interpret than surgeons did (p < 0.01) and NSD (p < 0.01). MoP found these data significantly more "difficult to understand" and were less likely to both spot "outliers" and use this data to inform decisions than doctors. Surgeons should be aware that outcome data may require an alternative method of presentation to be understood by MoP. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

  17. Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

    Science.gov (United States)

    Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

    2014-01-01

    Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

  18. Conflict Prevalence in Primary School and How It Is Understood to Affect Teaching and Learning in Ghana

    Directory of Open Access Journals (Sweden)

    Nana Afia Amponsaa Opoku-Asare

    2015-07-01

    Full Text Available Verbal and non-verbal interactions that occur daily between teachers and headteachers, teachers and pupils, and among pupils can generate conflict that may adversely affect teaching, learning, and schooling effectiveness. Little attention is, however, paid to the quality of relationships that exists between teachers and pupils, among teachers, among pupils, between teachers and their school heads, and between schools and their local communities. This study sought to investigate conflict prevalence in Ghana’s primary schools, and how relationship conflict is understood to affect teaching and learning at the level of headteachers as administrators, teachers as classroom managers, and pupils as learners, and direct beneficiaries of primary education. Using data gathered via interview, questionnaire administration, and observation in 30 public primary schools in 10 circuits of one district of Ashanti Region, the findings revealed a high prevalence of fighting, heckling, bullying, and other forms of relationship conflict among pupils; strained teacher–pupil relations due to insolence, indiscipline, and use of offensive language; and teacher–parent arguments and quarrels due to harsh punishment and verbal assault of pupils. Teacher–pupil conflicts may extend to teachers excluding the affected pupils from teaching and learning activities, denying them the rights to ask and answer questions, and have their class exercises marked, leading to lowered pupil self-esteem, reduced concentration during lessons, and passive involvement in learning activities, which could result in truancy and school dropout. Strengthening guidance mechanisms and encouraging peer mediation could significantly curb conflict in school environments and thereby raise educational standards in the district.

  19. Emergency procedures

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  20. GLP-2: A POORLY UNDERSTOOD MEDIATOR ENROLLED IN VARIOUS BARIATRIC/METABOLIC SURGERY-RELATED PATHOPHYSIOLOGIC MECHANISMS

    Science.gov (United States)

    CAZZO, Everton; GESTIC, Martinho Antonio; UTRINI, Murillo Pimentel; CHAIM, Felipe David Mendonça; GELONEZE, Bruno; PAREJA, José Carlos; CHAIM, Elinton Adami; MAGRO, Daniéla Oliveira

    2016-01-01

    ABSTRACT Introduction: Glucagon-like peptide-2 (GLP-2) is a gastrointestinal hormone whose effects are predominantly trophic on the intestinal mucosa. Aim: Critically evaluate the current literature on the influence of bariatric/metabolic surgery on the levels of GLP-2 and its potential clinical implications. Method s: Narrative review through online research on the databases Medline and Lilacs. There were six prospective human studies, two cross-sectional human studies, and three experimental animal studies selected. Results: There is evidence demonstrating significant increase in the levels of GLP-2 following gastric bypass, Scopinaro operation, and sleeve gastrectomy. There are no differences between gastric bypass and sleeve gastrectomy in regards to the increase in the GLP-2 levels. There is no correlation between the postoperative levels of GLP-2 and the occurrence of adequate or insufficient postoperative weight loss. Conclusion: GLP-2 plays significant roles on the regulation of nutrient absorption, permeability of gut mucosa, control of bone resorption, and regulation of satiety. The overall impact of these effects potentially exerts a significant adaptive or compensatory effect within the context of varied bariatric surgical techniques. PMID:28076485

  1. Video game addiction in emerging adulthood: Cross-sectional evidence of pathology in video game addicts as compared to matched healthy controls.

    Science.gov (United States)

    Stockdale, Laura; Coyne, Sarah M

    2018-01-01

    The Internet Gaming Disorder Scale (IGDS) is a widely used measure of video game addiction, a pathology affecting a small percentage of all people who play video games. Emerging adult males are significantly more likely to be video game addicts. Few researchers have examined how people who qualify as video game addicts based on the IGDS compared to matched controls based on age, gender, race, and marital status. The current study compared IGDS video game addicts to matched non-addicts in terms of their mental, physical, social-emotional health using self-report, survey methods. Addicts had poorer mental health and cognitive functioning including poorer impulse control and ADHD symptoms compared to controls. Additionally, addicts displayed increased emotional difficulties including increased depression and anxiety, felt more socially isolated, and were more likely to display internet pornography pathological use symptoms. Female video game addicts were at unique risk for negative outcomes. The sample for this study was undergraduate college students and self-report measures were used. Participants who met the IGDS criteria for video game addiction displayed poorer emotional, physical, mental, and social health, adding to the growing evidence that video game addictions are a valid phenomenon. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Plasmodium knowlesi from archival blood films: Further evidence that human infections are widely distributed and not newly emergent in Malaysian Borneo

    Science.gov (United States)

    Lee, Kim-Sung; Cox-Singh, Janet; Brooke, George; Matusop, Asmad; Singh, Balbir

    2009-01-01

    Human infections with Plasmodium knowlesi have been misdiagnosed by microscopy as Plasmodium malariae due to their morphological similarities. Although microscopy-identified P. malariae cases have been reported in the state of Sarawak (Malaysian Borno) as early as 1952, recent epidemiological studies suggest the absence of indigenous P. malariae infections. The present study aimed to determine the past incidence and distribution of P. knowlesi infections in the state of Sarawak based on archival blood films from patients diagnosed by microscopy as having P. malariae infections. Nested PCR assays were used to identify Plasmodium species in DNA extracted from 47 thick blood films collected in 1996 from patients in seven different divisions throughout the state of Sarawak. Plasmodium knowlesi DNA was detected in 35 (97.2%) of 36 blood films that were positive for Plasmodium DNA, with patients originating from all seven divisions. Only one sample was positive for P. malariae DNA. This study provides further evidence of the widespread distribution of human infections with P. knowlesi in Sarawak and its past occurrence. Taken together with data from previous studies, our findings suggest that P. knowlesi malaria is not a newly emergent disease in humans. PMID:19358848

  3. Effects of Performance Feedback Reports on Adherence to Evidence-Based Guidelines in Use of CT for Evaluation of Pulmonary Embolism in the Emergency Department: A Randomized Trial.

    Science.gov (United States)

    Raja, Ali S; Ip, Ivan K; Dunne, Ruth M; Schuur, Jeremiah D; Mills, Angela M; Khorasani, Ramin

    2015-11-01

    The purpose of this study was to assess whether implementing emergency department (ED) physician performance feedback reports improves adherence to evidence-based guidelines for use of CT for evaluation of pulmonary embolism (PE) beyond that achieved with clinical decision support (CDS) alone. This prospective randomized controlled trial was conducted from January 1, 2012, to December 31, 2013, at an urban level 1 adult trauma center ED. Attending physicians were stratified into quartiles by use of CT for evaluation of PE in 2012 and were randomized to receive quarterly feedback reporting or not, beginning January 2013. Reports consisted of individual and anonymized group data on guideline adherence (using the Wells criteria), use of CT for PE (number of CT examinations for PE per 1000 patients), and yield (percentage of CT examinations for PE with positive findings). We compared guideline adherence (primary outcome) and use and yield (secondary outcomes) of CT for PE between the control and intervention groups in 2013 and with historical imaging data from 2012. Of 109,793 ED patients during the control and intervention periods, 2167 (2.0%) underwent CT for evaluation of PE. In the control group, guideline adherence remained unchanged between 2012 (78.8% [476/604]) and 2013 (77.2% [421/545]) (p = 0.5); in the intervention group, guideline adherence increased 8.8% after feedback report implementation, from 78.3% (426/544) to 85.2% (404/474) (p guidelines for use of CT for evaluation of PE in ED patients, enhancing the impact of CDS alone. These results suggest potentially synergistic effects of traditional performance improvement tools with CDS to improve guideline adherence.

  4. Posttraumatic stress disorder and anesthesia emergence.

    Science.gov (United States)

    Lovestrand, Donnamarie; Phipps, Steven; Lovestrand, Steven

    2013-06-01

    Emergence agitation or delirium is a known phenomenon in the postanesthesia period. The underlying cause is not definitively understood. In a U.S. Army hospital's postanesthesia care unit, combat-related posttraumatic stress disorder (PTSD) can complicate interventions. Scant evidence-based research exists on the issue. By presenting case studies of 2 patients who underwent different surgical procedures, the authors argue that traditional modalities to reorient and calm patients experiencing emergence agitation who have PTSD are not shown to be effective. The first procedure demonstrates outcomes in a situation handled through traditional interventions. The second procedure demonstrates outcomes after incorporation of evidence-driven interventions. The authors conclude that best practice includes a proper identification of patients at risk of emergence agitation, a minimally stimulating environment, intraoperative sympatholytic therapy, and patient and staff education. Although the case studies presented support these principles, research is needed to provide stronger evidence. Military medical and research personnel can take the lead on this issue and be a source for improved outcomes and high-quality patient care.

  5. Estratégia em negócios internacionais: evidência em uma trading company que atua entre economias emergentes International business strategy: evidence from a trading company that operates in emerging economies

    Directory of Open Access Journals (Sweden)

    Karim Marini Thomé

    2013-04-01

    economias emergentes foi identificado como a capacidade da firma em gerenciar as interfaces entre os recursos e capacidades da firma, as demandas de competitividade industrial e as condições e transições institucionais. Esta capacidade possibilitou à firma estudada se sobressair à dificuldade e a explorar oportunidades de negócios em diferentes partes do globo.This case study revisits the questions raised by Peng (2004; 2003 with respect to what drives firm strategy and the determinants of success or failure in international business. Specifically, the study investigates what drives the strategy of a trading company and determines its success in international business. The theoretical framework focuses on trading companies and the triangular relationships between these companies, their clients and their suppliers and on three approaches or bases of strategy in international business, those of industrial competitiveness, firm resources and capabilities, and institutional contexts and transitions. The study, descriptive and qualitative in nature, collected data by means of in-depth interviews, document analysis and non-participant observation during the period from July, 2010 to January, 2011. The firm selected for study is a trading company conducting a large percentage of its total transactions between emerging economies. Results demonstrate that there is no single driver of this trading company strategy. Rather, there was evidence of the use of a variety of strategies, driven at times by the demands of industrial competitiveness, at times by firm resources and capabilities, and at times by institutional conditions. Each driver corresponded to a specific moment in the trajectory of the trading company studied. In addition, there was no evidence neither of a linear chronological order for these drivers, nor of driver obsolescence. On the contrary, the evidence of the study suggests that drivers are cumulative and cyclical, requiring review and even re-thinking when

  6. Can delusions be understood linguistically?

    Science.gov (United States)

    Hinzen, Wolfram; Rosselló, Joana; McKenna, Peter

    2016-01-01

    ABSTRACT Delusions are widely believed to reflect disturbed cognitive function, but the nature of this remains elusive. The “un-Cartesian” cognitive-linguistic hypothesis maintains (a) that there is no thought separate from language, that is, there is no distinct mental space removed from language where “thinking” takes place; and (b) that a somewhat broadened concept of grammar is responsible for bestowing meaning on propositions, and this among other things gives them their quality of being true or false. It is argued that a loss of propositional meaning explains why delusions are false, impossible and sometimes fantastic. A closely related abnormality, failure of linguistic embedding, can additionally account for why delusions are held with fixed conviction and are not adequately justified by the patient. The un-Cartesian linguistic approach to delusions has points of contact with Frith’s theory that inability to form meta-representations underlies a range of schizophrenic symptoms. It may also be relevant to the nature of the “second factor” in monothematic delusions in neurological disease. Finally, it can inform the current debate about whether or not delusions really are beliefs. PMID:27322493

  7. Home is to be understood

    DEFF Research Database (Denmark)

    Buhl, Mie; Werner Hansen, Siv

    2018-01-01

    , and involved artists with refugee status (mainly from Syria), a group of local volunteers, and members of the museum staff. The project derived from the annual theme “ON THE MOVE” and culminated in an art exhibition and event on June 4th 2016. Up until then the museum had invited the artists to create artworks...... for the exhibition, while including the volunteers in the process, facilitating the meeting of those who are at home and those who are on the run. In this sense, the MFSK situates themselves as a social-political activist; a contemporary institution dealing with contemporary societal issues. The migrant and refugee...... of engaging with themes of refuge, home and exile? What are the implications of volunteering in such project? The paper’s discussions are framed by the theories of gallery education (Bishop, 2006; Mörsch, 2009), co-creation in museums (Simon, 2010), community arts (Kester, 2013), and draws on fieldwork...

  8. Can delusions be understood linguistically?

    Science.gov (United States)

    Hinzen, Wolfram; Rosselló, Joana; McKenna, Peter

    2016-07-01

    Delusions are widely believed to reflect disturbed cognitive function, but the nature of this remains elusive. The "un-Cartesian" cognitive-linguistic hypothesis maintains (a) that there is no thought separate from language, that is, there is no distinct mental space removed from language where "thinking" takes place; and (b) that a somewhat broadened concept of grammar is responsible for bestowing meaning on propositions, and this among other things gives them their quality of being true or false. It is argued that a loss of propositional meaning explains why delusions are false, impossible and sometimes fantastic. A closely related abnormality, failure of linguistic embedding, can additionally account for why delusions are held with fixed conviction and are not adequately justified by the patient. The un-Cartesian linguistic approach to delusions has points of contact with Frith's theory that inability to form meta-representations underlies a range of schizophrenic symptoms. It may also be relevant to the nature of the "second factor" in monothematic delusions in neurological disease. Finally, it can inform the current debate about whether or not delusions really are beliefs.

  9. How flares can be understood

    International Nuclear Information System (INIS)

    Severny, A.B.

    1977-01-01

    Specific features of the flare phenomenon which are important for understanding of flares are the following: (1) Fine structure of visible emission of flares, especially at the very beginning and in the pre-flare active region. This structure can be seen also in later stages of development as bright points, some of which exist from the flare beginning (Babin's observations at Crimea, 1972-1976). (2) Turbulent motion with velocities up to 250-300 km s -1 as can be estimated from broadening of emission lines. (3) Predominantly red asymmetry of emission lines in the explosive phase and during further development of flares. (4) 'Supersonic' velocities and supergravitational accelerations of separate moving masses of the flare plasma. (5) The appearance of flares in areas with high grad H, exceeding 0.1 G km -1 which is equivalent to regions of electric currents > approximately 10 11 A. (6) Strong variations of net magnetic flux through the active region, as it follows from Meudon, Crimean, and Sacramento Peak (Rust's) observations. (Auth.)

  10. We Have Not Understood Descartes.

    Science.gov (United States)

    Vallias, Andras

    1996-01-01

    Describes a personal involvement with digital media and the origins of the conception of the "diagrammatic" poem. Reflects on what is considered to be a poem in tune with today's computerized society. (PA)

  11. Diabetic Emergencies

    Science.gov (United States)

    ... Campaigns Share this! EmergencyCareForYou » Emergency 101 » Diabetic Emergencies Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  12. Feeling Heard & Understood in the Hospital Environment: Benchmarking Communication Quality Among Patients with Advanced Cancer Before and After Palliative Care Consultation.

    Science.gov (United States)

    Ingersoll, Luke T; Saeed, Fahad; Ladwig, Susan; Norton, Sally A; Anderson, Wendy; Alexander, Stewart C; Gramling, Robert

    2018-05-02

    Maximizing value in palliative care requires continued development and standardization of communication quality indicators. To describe the basic epidemiology of a newly-adopted patient-centered communication quality indicator for hospitalized palliative care patie9nts with advanced cancer. Cross-sectional analysis of 207 advanced cancer patients who received palliative care consultation at two medical centers in the United States. Participants completed the Heard & Understood quality indicator immediately before and the day following the initial palliative care consultation: "Over the past two days ["24 hours" for the post-consultation version], how much have you felt heard and understood by the doctors, nurses and hospital staff? Completely/Quite a Bit/Moderately/Slightly/Not at All". We categorized "Completely" as indicating ideal quality. Approximately one-third indicated ideal Heard & Understood quality before palliative care consultation. Age, financial security, emotional distress, preferences for comfort-longevity tradeoffs at end-of-life, and prognosis expectations were associated with pre-consultation quality. Among those with less-than-ideal quality at baseline, 56% rated feeling more Heard & Understood the day following palliative care consultation. The greatest pre-post improvement was among people who had unformed end-of-life treatment preferences or who reported having "no idea" about their prognosis at baseline. Most patients felt incompletely heard and understood at the time of referral to palliative care consultation and more than half improved following consultation. Feeling heard and understood is an important quality indicator sensitive to interventions to improve care and key variations in the patient experience. Copyright © 2018. Published by Elsevier Inc.

  13. Emergency Communication

    Science.gov (United States)

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

  14. Childhood Emergencies

    Science.gov (United States)

    ... SUBSCRIBE Emergency 101 Share this! Home » Emergency 101 Childhood Emergencies Keeping children healthy and safe is every ... and tools to prevent, recognize and address a childhood emergency is the first step in keeping your ...

  15. Eye Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Eye Emergencies Lung Emergencies Surgeries Eye Emergencies Marfan syndrome significantly increases your risk of retinal detachment, a ...

  16. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... IUD placed inside the uterus CHOICES FOR EMERGENCY CONTRACEPTION Two emergency contraceptive pills may be bought without a prescription. ...

  17. Coupling between stress coping style and time of emergence from spawning nests in salmonid fishes: Evidence from selected rainbow trout strains (Oncorhynchus mykiss)

    DEFF Research Database (Denmark)

    Andersson, Madelene Åberg; Khan, Uniza Wahid; Øverli, Øyvind

    2013-01-01

    Correlations between behavioral and physiological traits, often referred to as stress coping styles, have been demonstrated in numerous animal groups. Such trait variations often cluster in two contrasting styles, with animals characterized as either proactive or reactive. In natural populations....../shyness, dominance, and metabolic rate; resembling those of proactive and reactive stress coping styles. In farmed fish populations, however the relation between emergence and stress coping styles seems to be absent, an effect which has been related to lack of selection pressure during emergence. In the present...... study two rainbow trout strains genetically selected as LR (low-responsive) and HR (high-responsive) trout, characterized with proactive (LR) and reactive (HR) stress coping traits, was used to further investigate the relationship between the time of emergence and stress coping style in salmonid fishes...

  18. Male emergence schedule and dispersal behaviour are modified by mate availability in heterogeneous landscapes: evidence from the orange-tip butterfly

    Directory of Open Access Journals (Sweden)

    W James Davies

    2015-01-01

    Full Text Available Protandry (prior emergence of males in insect populations is usually considered to be the result of natural selection acting directly on eclosion timing. When females are monandrous (mate once, males in high density populations benefit from early emergence in the intense scramble competition for mates. In low density populations, however, scramble competition is reduced or absent, and theoretical models predict that protandry will be less favoured. This raises the question of how males behave in heterogeneous landscapes characterized by high density core populations in a low density continuum. We hypothesized that disadvantaged late emerging males in a core population would disperse to the continuum to find mates. We tested this idea using the protandrous, monandrous, pierid butterfly Anthocharis cardamines (the orange-tip in a core population in Cheshire, northwest England. Over a six-year period, predicted male fitness (the number of matings a male can expect during his residence time, determined by the daily ratio of virgin females to competing males consistently declined to <1 in late season. This decline affected a large proportion (∼44% of males in the population and was strongly associated with decreased male recapture-rates, which we attribute to dispersal to the surrounding continuum. In contrast, reanalysis of mark-release-recapture data from an isolated population in Durham, northeast England, showed that in the absence of a continuum very few males (∼3% emerged when fitness declined to <1 in late season. Hence the existence of a low density continuum may lead to the evolution of plastic dispersal behaviour in high density core populations, maintaining late emerging males which would otherwise be eliminated by selection. This has important theoretical consequences, since a truncated male emergence curve is a key prediction in game theoretic models of emergence timing which has so far received limited support. Our results have

  19. Overview of evidence on emergency carotid stenting in patients with acute ischemic stroke due to tandem occlusions: a systematic review and meta-analysis.

    Science.gov (United States)

    Coelho, Andreia; Lobo, Miguel; Gouveia, Ricardo; Silveira, Diogo; Campos, Jacinta; Augusto, Rita; Coelho, Nuno; Canedo, Alexandra

    2018-01-23

    Endovascular intracranial thrombectomy (IT) has established itself as the standard of care in treating large-vessel anterior circulation acute ischemic stroke (AIS). However, internal carotid artery (ICA) stenosis/occlusion hampers distal access and controversy about simultaneous emergency ICA stenting ensues. The purpose of this review was to evaluate the safety of emergency ICA stenting in combination with IT for AIS with tandem occlusions. To our knowledge this is the first meta-analysis to evaluate emergency ICA stenting in tandem occlusions, combining results from studies with a control group. A systematic review and meta-analysis was conducted according to the recommendations of the Preferred Reporting Items for Systematic reviews and Meta- Analyses (PRISMA) statement. A total of 649 potentially relevant articles were initially selected. After reviewing at title or abstract level, 87 articles were read in full and 23 were included. These studies recruited 1000 patients, 220 submitted to IT with no emergency ICA stenting and 780 to IT and emergency ICA stenting. Successful revascularization (Thrombolysis in cerebral infarction scale - TICI≥2b) was achieved in 48.6-100%. Good outcome (modified Rankin scale - mRS≤2) ranged from 18.2-100%. Symptomatic intracranial haemorrhage (sICH) ranged from 0-45.7% (overall n=168; 17.2%). Mortality at 90 days ranged from 0-45.4% (overall n=114; 11.7%). Time to recanalization was significantly longer in the stenting group with an overall mean difference of 1.76 (95% Confidence Interval: 1.59-1.93). In this meta-analysis time to recanalization was significantly longer in the emergency ICA stenting group. There was no benefit from emergency stenting in parameters such as successful revascularization (TICI≥2b), clinical outcome (mRS≤2) or 90-day mortality. Data on sICH were scarce. Emergency ICA stenting appears to increase time to revascularization and increase the risk of complications with no demonstrated clinical

  20. Psychiatric Disorders and Personality Profiles of Middle-Aged Suicide Attempters with no Evidence of Specific Psychopathological Profiles Referring to an Emergency Department

    Directory of Open Access Journals (Sweden)

    Serge Brand

    2017-10-01

    Full Text Available Objective: The aim of the present study was to assess socio-demographic and psychiatric characteristics of 40-65 years old suicide attempters referred to an emergency department within four hours of making their attempt.Method: We assessed a total of 93 suicide attempters (Mage=46.59 years referred to an emergency department. Patients completed questionnaires covering socio-demographic data, personality traits, mood, and impulsivity; experts rated patients’ psychiatric status.Results: Experts rated 85 (92.4% of the suicide attempters as having a psychiatric disorder. Based on self-ratings and compared to normative data, 42 (46.6% were psychopathologically ill. Suicide attempts were not related to impulsive personality traits, mood disorders, socio-demographic patterns or gender (gender-ratio: 1:1.58;f:m.Conclusions: The pattern of results suggests that further unknown factors were involved in pushing people to attempt suicide.

  1. Psychiatric Disorders and Personality Profiles of Middle-Aged Suicide Attempters with No Evidence of Specific Psychopathological Profiles Referred to an Emergency Department

    Science.gov (United States)

    Brand, Serge; Nejat, Mehri; Haghighi, Mohammad; Rahimi, Alireza; Jahangard, Leila; Sadeghi Bahmani, Dena; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Ahmadpanah, Mohammad

    2017-01-01

    Objective: The present study aimed at assessing the sociodemographic and psychiatric characteristics of 40 to 65 year- old suicide attempters, who were referred to an emergency department within 4 hours of the attempt. Method: A total of 93 suicide attempters (Mean age=46.59 years) who were referred to an emergency department, were assessed in this study. Patients completed questionnaires covering sociodemographic data, personality traits, mood, and impulsivity. Psychiatric status of the patients was rated by experts. Results: Experts rated 85 (92.4%) of the suicide attempters as having a psychiatric disorder. Based on self-ratings and compared to normative data, 42 (46.6%) patients were psychopathologically ill. It was found that suicide attempts were not related to impulsive personality traits, mood disorders, sociodemographic patterns, or gender (gender-ratio: 1:1.58; f: m). Conclusion: The pattern of results suggests that further unknown factors were involved in pushing people to attempt suicide. PMID:29472951

  2. Psychiatric Disorders and Personality Profiles of Middle-Aged Suicide Attempters with No Evidence of Specific Psychopathological Profiles Referred to an Emergency Department.

    Science.gov (United States)

    Brand, Serge; Nejat, Mehri; Haghighi, Mohammad; Rahimi, Alireza; Jahangard, Leila; Sadeghi Bahmani, Dena; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Ahmadpanah, Mohammad

    2017-10-01

    Objective: The present study aimed at assessing the sociodemographic and psychiatric characteristics of 40 to 65 year- old suicide attempters, who were referred to an emergency department within 4 hours of the attempt. Method: A total of 93 suicide attempters (Mean age=46.59 years) who were referred to an emergency department, were assessed in this study. Patients completed questionnaires covering sociodemographic data, personality traits, mood, and impulsivity. Psychiatric status of the patients was rated by experts. Results: Experts rated 85 (92.4%) of the suicide attempters as having a psychiatric disorder. Based on self-ratings and compared to normative data, 42 (46.6%) patients were psychopathologically ill. It was found that suicide attempts were not related to impulsive personality traits, mood disorders, sociodemographic patterns, or gender (gender-ratio: 1:1.58; f: m). Conclusion: The pattern of results suggests that further unknown factors were involved in pushing people to attempt suicide.

  3. Lung Emergencies

    Science.gov (United States)

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

  4. Factors Associated with the Emergence of Highly Pathogenic Avian Influenza A (H5N1) Poultry Outbreaks in China: Evidence from an Epidemiological Investigation in Ningxia, 2012.

    Science.gov (United States)

    Liu, H; Zhou, X; Zhao, Y; Zheng, D; Wang, J; Wang, X; Castellan, D; Huang, B; Wang, Z; Soares Magalhães, R J

    2017-06-01

    In April 2012, highly pathogenic avian influenza virus of the H5N1 subtype (HPAIV H5N1) emerged in poultry layers in Ningxia. A retrospective case-control study was conducted to identify possible risk factors associated with the emergence of H5N1 infection and describe and quantify the spatial variation in H5N1 infection. A multivariable logistic regression model was used to identify risk factors significantly associated with the presence of infection; residual spatial variation in H5N1 risk unaccounted by the factors included in the multivariable model was investigated using a semivariogram. Our results indicate that HPAIV H5N1-infected farms were three times more likely to improperly dispose farm waste [adjusted OR = 0.37; 95% CI: 0.12-0.82] and five times more likely to have had visitors in their farm within the past month [adjusted OR = 5.47; 95% CI: 1.97-15.64] compared to H5N1-non-infected farms. The variables included in the final multivariable model accounted only 20% for the spatial clustering of H5N1 infection. The average size of a H5N1 cluster was 660 m. Bio-exclusion practices should be strengthened on poultry farms to prevent further emergence of H5N1 infection. For future poultry depopulation, operations should consider H5N1 disease clusters to be as large as 700 m. © 2015 Blackwell Verlag GmbH.

  5. Emergence in Dynamical Systems

    Directory of Open Access Journals (Sweden)

    John Collier

    2013-12-01

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

  6. Historicism and Industry Emergence

    DEFF Research Database (Denmark)

    Kirsch, David; Moeen, Mahka; Wadhwani, Dan

    2014-01-01

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

  7. Emergence of a high-temperature superconductivity in hydrogen cycled Pd compounds as an evidence for super-stoichiometric H/D sites

    Energy Technology Data Exchange (ETDEWEB)

    Lipson, Andrei; Castano, Carlos; Miley, George [University of Illinois at Urbana - Champaign, lL (United States); Lipson, Andrei; Lyakhov, Boris [lnstitute of Physical Chemistry, RAS, Moscow (Russian Federation); Mitin, Alexander [P. Kapitza Institute for Physical Problems, RAS, Moscow (Russian Federation)

    2006-07-01

    Transport and magnetic properties of hydrogen cycled PdH{sub x} and Pd/PdO:H{sub x} (x {approx} = (4/6) x 10{sup -4}) nano-composite consisting of a Pd matrix with hydrogen trapped inside dislocation cores have been studied. The results suggest emergence of a high-temperature superconductivity stale of a condensed hydrogen phase confined inside deep dislocation cores in the Pd matrix. The possible role of hydrogen/deuterium filled dislocation nano-tubes is discussed. These dislocation cores could be considered as active centers of LENR triggering due to (i) short D-D separation distance ({approx}Bohr radius); (ii) high-local D-loading in the Pd and the corresponding effective lattice compression; (iii) a large optic phonon energy resulting in a most effective lattice-nuclei energy transfer.

  8. Emergence of a high-temperature superconductivity in hydrogen cycled Pd compounds as an evidence for super-stoichiometric H/D sites

    International Nuclear Information System (INIS)

    Lipson, Andrei; Castano, Carlos; Miley, George; Lipson, Andrei; Lyakhov, Boris; Mitin, Alexander

    2006-01-01

    Transport and magnetic properties of hydrogen cycled PdH x and Pd/PdO:H x (x ∼ = (4/6) x 10 -4 ) nano-composite consisting of a Pd matrix with hydrogen trapped inside dislocation cores have been studied. The results suggest emergence of a high-temperature superconductivity stale of a condensed hydrogen phase confined inside deep dislocation cores in the Pd matrix. The possible role of hydrogen/deuterium filled dislocation nano-tubes is discussed. These dislocation cores could be considered as active centers of LENR triggering due to (i) short D-D separation distance (∼Bohr radius); (ii) high-local D-loading in the Pd and the corresponding effective lattice compression; (iii) a large optic phonon energy resulting in a most effective lattice-nuclei energy transfer

  9. Emergence of a High-Temperature Superconductivity in Hydrogen Cycled pd Compounds as AN Evidence for Superstoihiometric H/d Sites

    Science.gov (United States)

    Lipson, Andrei; Castano, Carlos; Miley, George; Lipson, Andrei; Lyakhov, Boris; Mitin, Alexander

    2006-02-01

    Transport and magnetic properties of hydrogen cycled PdHx and Pd/PdO:Hx (x ~ (4/6) × 10-4) nano-composite consisting of a Pd matrix with hydrogen trapped inside dislocation cores have been studied. The results suggest emergence of a high-temperature superconductivity state of a condensed hydrogen phase confined inside deep dislocation cores in the Pd matrix. The possible role of hydrogen/deuterium filled dislocation nano-tubes is discussed. These dislocation cores could be considered as active centers of LENR triggering due to (i) short D-D separation distance (~Bohr radius); (ii) high-local D-loading in the Pd and the corresponding effective lattice compression; (iii) a large optic phonon energy resulting in a most effective lattice-nuclei energy transfer.

  10. Time to Amyloid Positivity and Preclinical Changes in Brain Metabolism, Atrophy, and Cognition: Evidence for Emerging Amyloid Pathology in Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Philip S. Insel

    2017-05-01

    Full Text Available Background: Aβ pathology is associated with longitudinal changes of brain metabolism, atrophy, and cognition, in cognitively healthy elders. However, Aβ information is usually measured cross-sectionally and dichotomized to classify subjects as Aβ-positive or Aβ-negative, making it difficult to evaluate when brain and cognitive changes occur with respect to emerging Aβ pathology. In this study, we use longitudinal Aβ information to combine the level and rate of change of Aβ to estimate the time to Aβ-positivity for each subject and test this temporal proximity to significant Aβ pathology for associations with brain structure, metabolism, and cognition.Methods: In 89 cognitively healthy elders with up to 10 years of follow-up, we estimated the points at which rates of fluorodeoxyglucose (FDG PET, MRI, and cognitive and functional decline begin to accelerate with respect to the time to Aβ-positivity. Points of initial acceleration in rates of decline were estimated using mixed-effects models with penalized regression splines.Results: Acceleration of rates of FDG PET were observed to occur 20+ years before the conventional threshold for Aβ-positivity. Subtle signs of cognitive dysfunction were observed 10+ years before Aβ-positivity.Conclusions: Aβ may have subtle associations with other hallmarks of Alzheimer's disease before Aβ biomarkers reach conventional thresholds for Aβ-positivity. Therefore, we propose that emerging Aβ pathology occurs many years before cognitively healthy elders reach the current threshold for Aβ positivity (preclinical AD. To allow prevention in the earliest disease stages, AD clinical trials may be designed to also include subjects with Aβ biomarkers in the sub-threshold range.

  11. A systematic review of management strategies for children's mental health care in the emergency department: update on evidence and recommendations for clinical practice and research.

    Science.gov (United States)

    Newton, Amanda S; Hartling, Lisa; Soleimani, Amir; Kirkland, Scott; Dyson, Michele P; Cappelli, Mario

    2017-06-01

    Children with mental health crises require access to specialised resources and services which are not yet standard in general and paediatric EDs. In 2010, we published a systematic review that provided some evidence to support the use of specialised care models to reduce hospitalisation, return ED visits and length of ED stay. We perform a systematic review to update the evidence base and inform current policy statements. Twelve databases and the grey literature were searched up to January 2015. Seven studies were included in the review (four newly identified studies). These studies compared ED-based strategies designed to assess, treat and/or therapeutically support or manage a mental health presentation. The methodological quality of six studies was assessed using the Cochrane Effective Practice and Organization of Care Risk of Bias tool (one interrupted time series study) and a modified Newcastle-Ottawa Scale (three retrospective cohort and two before-after studies). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was applied to rate overall evidence quality (high, moderate, low or very low) for individual outcomes from these six studies. An additional study evaluated the psychometric properties of a clinical instrument and was assessed using criteria developed by the Society of Pediatric Psychology Assessment Task Force (well-established, approaching well-established or promising assessment). There is low to very low overall evidence quality that: (1) use of screening laboratory tests to medically clear mental health patients increases length of ED stay and costs, but does not increase the risk of clinical management or disposition change if not conducted; and (2) specialised models of ED care reduce lengths of ED stay, security man-hours and restraint orders. One mental health assessment tool of promising quality, the home, education, activities and peers, drugs and alcohol, suicidality, emotions and behaviour, discharge

  12. Towards evidence-based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 2: Is there value in testing troponin levels after ICD discharge?

    Science.gov (United States)

    Targett, Chris; Harris, Tim

    2014-03-01

    A short cut review was carried out to establish whether testing for troponin levels is useful after discharge of an Implanted Cardioverter-Defibrillator (ICD). Many papers were found using the reported searches, none of which directly addressed the problem but some 13 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of those best papers are tabulated. It is concluded that the number of ICD discharges must be taken into account when evaluating any troponin level rise. Overall a positive troponin assay post ICD discharge is independently associated with an increased mortality.

  13. Relationship between implementing interpersonal communication and mass education campaigns in emergency settings and use of reproductive healthcare services: evidence from Darfur, Sudan.

    Science.gov (United States)

    Adam, Izzeldin Fadl; Nakamura, Keiko; Kizuki, Masashi; Al Rifai, Rami; Vanching, Urnaa

    2015-09-15

    (1) To examine changes in women's awareness and utilisation of reproductive healthcare services in emergency settings following provision of interpersonal communication (IPC) and mass education campaigns, and (2) to describe factors associated with reproductive healthcare service use in internally displaced person (IDP) camps. Three camps containing 88 984 IDPs in Darfur, Sudan. 640 women aged 15-49 who had experienced pregnancy in the camp during the previous 2 years were enrolled in each of two independent cross-sectional surveys 26 months apart. IPC and mass education campaigns where community health workers disseminated information by home/shelter visits, clinic sessions, public meetings and other means to raise awareness and promote reproductive healthcare service use. Awareness of the existence of antenatal care (ANC) and tetanus toxoid (TT) vaccination services, reception of ANC and TT vaccination, place of delivery and use of postnatal care (PNC). The percentage of women who received home visits, and attended in-clinic sessions and public meetings increased from 61.6% to 86.7%, from 43.0% to 68.8%, and from 3.8% to 39.8%, respectively, between the initial and follow-up surveys. More women were aware of ANC (OR 18.6, 95% CI 13.1 to 26.5) and TT vaccination (OR 3.2, 95% CI 2.4 to 4.4) in the follow-up than the initial survey, after multivariable adjustment. More women received ≥3 ANC visits (OR 8.8, 95% CI 6.4 to 12.0) and ≥3 doses of TT (OR 2.5, 95% CI 1.9 to 3.3), delivered at a healthcare facility (OR 5.4, 95% CI 4.0 to 7.4) and received a PNC visit (OR 5.5, 95% CI 4.0 to 7.7) in the follow-up than in the initial survey, after multivariable adjustment. Awareness about and utilisation of reproductive healthcare services were higher in the follow-up survey. An integrated IPC and mass education campaign is effective for improving women's reproductive health in emergency settings. Published by the BMJ Publishing Group Limited. For permission to use

  14. Natural tracers for identifying the origin of the thermal fluids emerging along the Aegean Volcanic arc (Greece): Evidence of Arc-Type Magmatic Water (ATMW) participation

    Science.gov (United States)

    Dotsika, E.; Poutoukis, D.; Michelot, J. L.; Raco, B.

    2009-01-01

    The Aegean volcanic arc is the result of a lithosphere subduction process during the Quaternary time. Starting from the Soussaki area, from west to east, the arc proceeds through the islands of Egina, Methana, Milos, Santorini, the Columbus Bank, Kos and Nisyros. Volcano-tectonic activities are still pronounced at Santorini and Nisyros in form of seismic activity, craters of hydrothermal explosions, hot fumaroles and thermal springs. A significant number of cold water springs emerge in the vicinity of hot waters on these islands. Chemical and isotopic analyses were applied on water and fumaroles samples collected in different areas of the volcanic arc in order to attempt the assessment of these fluids. Stable isotopes of water and carbon have been used to evaluate the origin of cold and thermal water and CO 2. Chemical solute concentrations and isotopic contents of waters show that the fluids emerging in Egina, Soussaki, Methana and Kos areas represent geothermal systems in their waning stage, while the fluids from Milos, Santorini and Nisyros proceed from active geothermal systems. The δ 2H-δ 18O-Cl - relationships suggest that the parent hydrothermal liquids of Nisyros and Milos are produced through mixing of seawater and Arc-Type Magmatic Water (ATMW), with negligible to nil contribution of local ground waters and with very high participation of the magmatic component, which is close to 70% in both sites. A very high magmatic contribution to the deep geothermal system could occur at Santorini as well, perhaps with a percentage similar to Nisyros and Milos, but it cannot be calculated because of steam condensation heavily affecting the fumarolic fluids of Nea Kameni before the surface discharge. The parent hydrothermal liquid at Methana originates through mixing of local groundwaters, seawater and ATMW, with a magmatic participation close to 19%. All in all, the contribution of ATMW is higher in the central-eastern part of the Aegean volcanic arc than in the

  15. Emerging Evidence for the Importance of Dietary Protein Source on Glucoregulatory Markers and Type 2 Diabetes: Different Effects of Dairy, Meat, Fish, Egg, and Plant Protein Foods

    Directory of Open Access Journals (Sweden)

    Kevin B. Comerford

    2016-07-01

    Full Text Available Observational studies provide evidence that a higher intake of protein from plant-based foods and certain animal-based foods is associated with a lower risk for type 2 diabetes. However, there are few distinguishable differences between the glucoregulatory qualities of the proteins in plant-based foods, and it is likely their numerous non-protein components (e.g., fibers and phytochemicals that drive the relationship with type 2 diabetes risk reduction. Conversely, the glucoregulatory qualities of the proteins in animal-based foods are extremely divergent, with a higher intake of certain animal-based protein foods showing negative effects, and others showing neutral or positive effects on type 2 diabetes risk. Among the various types of animal-based protein foods, a higher intake of dairy products (such as milk, yogurt, cheese and whey protein consistently shows a beneficial relationship with glucose regulation and/or type 2 diabetes risk reduction. Intervention studies provide evidence that dairy proteins have more potent effects on insulin and incretin secretion compared to other commonly consumed animal proteins. In addition to their protein components, such as insulinogenic amino acids and bioactive peptides, dairy products also contain a food matrix rich in calcium, magnesium, potassium, trans-palmitoleic fatty acids, and low-glycemic index sugars—all of which have been shown to have beneficial effects on aspects of glucose control, insulin secretion, insulin sensitivity and/or type 2 diabetes risk. Furthermore, fermentation and fortification of dairy products with probiotics and vitamin D may improve a dairy product’s glucoregulatory effects.

  16. Evidence for Isostatic Emergence and Holocene Environmental Change Recorded in Chironomid Assemblages and Sediment Composition of Coastal Lake T1 in SW Greenland

    Science.gov (United States)

    Berman, K.; Axford, Y.; Lasher, G. E.

    2017-12-01

    Multi-proxy analysis of a coastal lake in southwest Greenland near Nuuk provides evidence for regional environmental changes, including the timing of isostatic rebound and the temperature history of the area. T1 (informal name) is a small lake 50 km south of Nuuk, at 17.5 m elevation and currently isolated from glacial meltwater drainage. The lake's sediment record begins approximately 9500 cal years BP, when the site was submerged beneath sea level due to glacial isostatic depression following the Last Glacial Maximum. The record captures the transition of the environment from a submerged, glacially-influenced marine site to a non-glacially fed (and initially meromictic) freshwater lake 8600 cal years BP. Magnetic susceptibility, a proxy for sediment minerogenic content, decreased rapidly from 9500 to 8600 years BP, before abruptly stabilizing and remaining relatively low and steady for the rest of the record. The transition to a lacustrine environment was characterized by a rapid and relatively simultaneous increase in primary productivity (inferred from biogenic silica concentrations) and shift towards terrestrial versus marine sources of organic matter (inferred from carbon:nitrogen ratios and nitrogen isotopes) between 8700 and 8400 years BP. Together, these proxies and the presence of marine shells below the transition provide robust evidence for the transition from a marine environment to a freshwater lake in response to regional postglacial isostatic rebound. Within the Holocene, measures of bulk sediment composition (e.g., biogenic silica, loss-on-ignition and magnetic susceptibility) are relatively stable. Chironomid (Insecta: Diptera: Chironomidae) assemblages, which in some environments are quantitative proxies for summer temperature changes, show species-level shifts within the Holocene that will be interpreted in this presentation alongside indicators of landscape change including carbon:nitrogen ratios, bulk sediment spectral reflectance and bulk

  17. Genome-Wide Analysis Provides Evidence on the Genetic Relatedness of the Emergent Xylella fastidiosa Genotype in Italy to Isolates from Central America.

    Science.gov (United States)

    Giampetruzzi, Annalisa; Saponari, Maria; Loconsole, Giuliana; Boscia, Donato; Savino, Vito Nicola; Almeida, Rodrigo P P; Zicca, Stefania; Landa, Blanca B; Chacón-Diaz, Carlos; Saldarelli, Pasquale

    2017-07-01

    Xylella fastidiosa is a plant-pathogenic bacterium recently introduced in Europe that is causing decline in olive trees in the South of Italy. Genetic studies have consistently shown that the bacterial genotype recovered from infected olive trees belongs to the sequence type ST53 within subspecies pauca. This genotype, ST53, has also been reported to occur in Costa Rica. The ancestry of ST53 was recently clarified, showing it contains alleles that are monophyletic with those of subsp. pauca in South America. To more robustly determine the phylogenetic placement of ST53 within X. fastidiosa, we performed a comparative analysis based on single nucleotide polymorphisms (SNPs) and the study of the pan-genome of the 27 currently public available whole genome sequences of X. fastidiosa. The resulting maximum-parsimony and maximum likelihood trees constructed using the SNPs and the pan-genome analysis are consistent with previously described X. fastidiosa taxonomy, distinguishing the subsp. fastidiosa, multiplex, pauca, sandyi, and morus. Within the subsp. pauca, the Italian and three Costa Rican isolates, all belonging to ST53, formed a compact phylotype in a clade divergent from the South American pauca isolates, also distinct from the recently described coffee isolate CFBP8072 imported into Europe from Ecuador. These findings were also supported by the gene characterization of a conjugative plasmid shared by all the four ST53 isolates. Furthermore, isolates of the ST53 clade possess an exclusive locus encoding a putative ATP-binding protein belonging to the family of histidine kinase-like ATPase gene, which is not present in isolates from the subspecies multiplex, sandyi, and pauca, but was detected in ST21 isolates of the subspecies fastidiosa from Costa Rica. The clustering and distinctiveness of the ST53 isolates supports the hypothesis of their common origin, and the limited genetic diversity among these isolates suggests this is an emerging clade within subsp

  18. Heterosis Is a Systemic Property Emerging From Non-linear Genotype-Phenotype Relationships: Evidence From in Vitro Genetics and Computer Simulations

    Directory of Open Access Journals (Sweden)

    Julie B. Fiévet

    2018-05-01

    Full Text Available Heterosis, the superiority of hybrids over their parents for quantitative traits, represents a crucial issue in plant and animal breeding as well as evolutionary biology. Heterosis has given rise to countless genetic, genomic and molecular studies, but has rarely been investigated from the point of view of systems biology. We hypothesized that heterosis is an emergent property of living systems resulting from frequent concave relationships between genotypic variables and phenotypes, or between different phenotypic levels. We chose the enzyme-flux relationship as a model of the concave genotype-phenotype (GP relationship, and showed that heterosis can be easily created in the laboratory. First, we reconstituted in vitro the upper part of glycolysis. We simulated genetic variability of enzyme activity by varying enzyme concentrations in test tubes. Mixing the content of “parental” tubes resulted in “hybrids,” whose fluxes were compared to the parental fluxes. Frequent heterotic fluxes were observed, under conditions that were determined analytically and confirmed by computer simulation. Second, to test this model in a more realistic situation, we modeled the glycolysis/fermentation network in yeast by considering one input flux, glucose, and two output fluxes, glycerol and acetaldehyde. We simulated genetic variability by randomly drawing parental enzyme concentrations under various conditions, and computed the parental and hybrid fluxes using a system of differential equations. Again we found that a majority of hybrids exhibited positive heterosis for metabolic fluxes. Cases of negative heterosis were due to local convexity between certain enzyme concentrations and fluxes. In both approaches, heterosis was maximized when the parents were phenotypically close and when the distributions of parental enzyme concentrations were contrasted and constrained. These conclusions are not restricted to metabolic systems: they only depend on the

  19. Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

    Science.gov (United States)

    Blancher, Marc; Albasini, François; Elsensohn, Fidel; Zafren, Ken; Hölzl, Natalie; McLaughlin, Kyle; Wheeler, Albert R; Roy, Steven; Brugger, Hermann; Greene, Mike; Paal, Peter

    2018-02-15

    Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue. High Alt Med Biol. 00:000-000, 2018. Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas. Details of MCI occurring in mountain areas related to mountaineering activities and involving organized mountain rescue were collected. A literature search using (1) PubMed, (2) national mountain rescue registries, and (3) lay press articles on the internet was performed. The results were analyzed with respect to specific aspects of mountain rescue. We identified 198 MCIs that have occurred in mountain areas since 1956: 137 avalanches, 38 ski lift accidents, and 23 other events, including lightning injuries, landslides, volcanic eruptions, lost groups of people, and water-related accidents. General knowledge on MCI management is required. Due to specific aspects of triage and management, the approach to MCIs may differ between those in mountain areas and those in urban settings. Mountain rescue teams should be prepared to manage MCIs. Knowledge should be reviewed and training performed regularly. Cooperation between terrestrial rescue services, avalanche safety authorities, and helicopter crews is critical to successful management of MCIs in mountain areas.

  20. Importance of Internet surveillance in public health emergency control and prevention: evidence from a digital epidemiologic study during avian influenza A H7N9 outbreaks.

    Science.gov (United States)

    Gu, Hua; Chen, Bin; Zhu, Honghong; Jiang, Tao; Wang, Xinyi; Chen, Lei; Jiang, Zhenggang; Zheng, Dawei; Jiang, Jianmin

    2014-01-17

    prevent and control the epidemic, including preparation of personnel, technology, and other resources; information release; collection of public opinion and reaction; and clarification, prevention, and control of rumors. Internet surveillance can be used as an efficient and economical tool to prevent and control public health emergencies, such as H7N9 outbreaks.

  1. Evidence for emergency vaccination having played a crucial role to control the 1965/66 foot-and-mouth disease outbreak in Switzerland

    Directory of Open Access Journals (Sweden)

    Dana eZingg

    2015-12-01

    Full Text Available Foot-and-mouth disease (FMD is a highly contagious disease which caused several large outbreaks in Europe in the last century. The last important outbreak in Switzerland took place in 1965/66 and affected more than 900 premises and more than 50,000 animals were slaughtered. Large scale emergency vaccination of the cattle and pig population has been applied to control the epidemic. In recent years, many studies have used infectious disease models to assess the impact of different disease control measures, including models developed for diseases exotic for the specific region of interest. Often, the absence of real outbreak data makes a validation of such models impossible. This study aimed to evaluate whether a spatial, stochastic simulation model (the Davis Animal Disease Simulation model can predict the course of a Swiss FMD epidemic based on the available historic input data on population structure, contact rates, epidemiology of the virus and quality of the vaccine. In addition, the potential outcome of the 1965/66 FMD epidemic without application of vaccination was investigated. Comparing the model outcomes to reality, only the largest 10% of the simulated outbreaks approximated the number of animals being culled. However, the simulation model highly overestimated the number of culled premises. While the outbreak duration could not be well reproduced by the model compared to the 1965/66 epidemic, it was able to accurately estimate the size of the area infected. Without application of vaccination the model predicted a much higher mean number of culled animals than with vaccination, demonstrating that vaccination was likely crucial in disease control for the Swiss FMD outbreak in 1965/66. The study demonstrated the feasibility to analyze historical outbreak data with modern analytical tools. However, it also confirmed that predicted epidemics from a most carefully parametrized model cannot integrate all eventualities of a real epidemic

  2. Synaptic clustering within dendrites: an emerging theory of memory formation

    Science.gov (United States)

    Kastellakis, George; Cai, Denise J.; Mednick, Sara C.; Silva, Alcino J.; Poirazi, Panayiota

    2015-01-01

    It is generally accepted that complex memories are stored in distributed representations throughout the brain, however the mechanisms underlying these representations are not understood. Here, we review recent findings regarding the subcellular mechanisms implicated in memory formation, which provide evidence for a dendrite-centered theory of memory. Plasticity-related phenomena which affect synaptic properties, such as synaptic tagging and capture, synaptic clustering, branch strength potentiation and spinogenesis provide the foundation for a model of memory storage that relies heavily on processes operating at the dendrite level. The emerging picture suggests that clusters of functionally related synapses may serve as key computational and memory storage units in the brain. We discuss both experimental evidence and theoretical models that support this hypothesis and explore its advantages for neuronal function. PMID:25576663

  3. Emerging Hopes

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

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

  4. An Inverse Problem Study: Credit Risk Ratings as a Determinant of Corporate Governance and Capital Structure in Emerging Markets: Evidence from Chinese Listed Companies

    Directory of Open Access Journals (Sweden)

    ManYing Kang

    2017-11-01

    Full Text Available Credit risk rating is shown to be a relevant determinant in order to estimate good corporate governance and to self-optimize capital structure. The conclusion is argued from a study on a selected (and justified sample of (182 companies listed on the Shanghai Stock Exchange (SHSE and the Shenzhen Stock Exchange (SZSE and which use the same Shanghai Brilliance Credit Rating & Investors Service Company (SBCR assessment criteria, for their credit ratings, from 2010 to 2015. Practically, 3 debt ratios are examined in terms of 11 characteristic variables. Moreover, any relationship between credit rating and corporate governance can be thought to be an interesting finding. The relationship we find between credit rating and leverage is not as evident as that found by other researchers for different countries; it is significantly positively related to the outside director, firm size, tangible assets and firm age, and CEO and chairman office plurality. However, leverage is found to be negatively correlated with board size, profitability, growth opportunity, and non-debt tax shield. Credit rating is positively associated with leverage, but in a less significant way. CEO-Board chairship duality is insignificantly related to leverage. The non-debt tax shield is significantly correlated with leverage. The correlation coefficient between CEO duality and auditor is positive but weakly significant, but seems not consistent with expectations. Finally, profitability cause could be regarded as an interesting finding. Indeed, there is an inverse correlation between profitability and total debt (Notice that the result supports the pecking order theory. In conclusion, it appears that credit rating has less effect on the so listed large Chinese companies than in other countries. Nevertheless, the perspective of assessing credit risk rating by relevant agencies is indubitably a recommended time dependent leverage determinant.

  5. Emergent Expertise?

    Science.gov (United States)

    McGivern, Patrick

    2014-01-01

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

  6. Spain as an emergency air traffic hub during volcanic air fall events? Evidence of past volcanic ash air fall over Europe during the late Pleistocene

    Science.gov (United States)

    Hardiman, Mark; Lane, Christine; Blockley, Simon P. E.; Moreno, Ana; Valero-Garcés, Blas; Ortiz, José E.; Torres, Trino; Lowe, John J.; Menzies, Martin A.

    2010-05-01

    Past volcanic eruptions often leave visible ash layers in the geological record, for example in marine or lake sedimentary sequences. Recent developments, however, have shown that non-visible volcanic ash layers are also commonly preserved in sedimentary deposits. These augment the record of past volcanic events by demonstrating that past ash dispersals have been more numerous and widely disseminated in Europe than previously appreciated. The dispersal ‘footprints' of some large late Pleistocene European eruptions are examined here in the light of the recent Eyjafjallajökull eruption. For example, the Vedde Ash which was erupted from Iceland around 12 thousand years ago, delivered distal (and non-visible) glass deposits as far south as Switzerland and as far east as the Ural Mountains in Russia, with an overall European distribution remarkably similar to the dominant tracks of the recent Eyjafjallajökull plumes. The Eyjafjallajökull eruption has demonstrated that relatively small amounts of distal volcanic ash in the atmosphere can seriously disrupt aviation activity, with attendant economic and other consequences. It has raised fundamental questions about the likelihood of larger or more prolonged volcanic activity in the near future, and the possibility of even more serious consequences than those experienced recently. Given that there are several other volcanic centres that could cause such disruption in Europe (e.g. Campania and other volcanic centres in Italy; Aegean volcanoes), a key question is whether there are parts of Europe less prone to ash plumes and which could therefore operate as emergency air traffic hubs during times of ash dispersal. Although not generated to answer this question, the recent geological record might provide a basis for seeking the answer. For example, four palaeo-records covering the time frame of 8 - 40 Ka BP that are geographically distributed across Spain have been examined for non-visible distal ash content. All four have

  7. Health, trust, or "just understood": explicit and implicit condom decision-making processes among black, white, and interracial same-sex male couples.

    Science.gov (United States)

    Campbell, Chadwick K; Gómez, Anu Manchikanti; Dworkin, Shari; Wilson, Patrick A; Grisham, Kirk K; McReynolds, Jaih; Vielehr, Peter; Hoff, Colleen

    2014-05-01

    Among gay and bisexual men, primary partners are a leading source of HIV infection. Trust, intimacy, and advancements in HIV treatment may impact same-sex male (SSM) couples' decisions to engage in unprotected anal intercourse (UAI). This qualitative study explored how Black, White and interracial couples discussed, and made decisions regarding condoms. Qualitative interviews were conducted with 48 SSM couples in the New York and San Francisco metropolitan areas. Stratified purposive sampling was used to include Black (n = 16), White (n = 17), and interracial (Black-White) (n = 15) couples. Twenty-six couples were concordant HIV-negative and 22 were HIV-discordant. Interviews were recorded, transcribed, coded, and analyzed using a grounded theory approach. Some couples described explicit processes, which involved active discussion, while others described implicit processes, where condom-use decisions occurred without any explicit discussion. These processes also differed by race and HIV status. Black couples tended to report condom-use as "just understood." White, HIV-discordant couples decided not to use condoms, with some identifying the HIV-positive partner's suppressed viral load and high CD4 count as deciding factors. After an unplanned episode of UAI, White, HIV-negative couples tended to discontinue condom use while Black HIV-negative couples decided to revert to using condoms. HIV prevention efforts focused on same-sex, male couples must consider the explicit/implicit nature of condom decision-making processes. Understanding differences in these processes and considering relationship dynamics, across race and HIV status, can promote the development of innovative couple-level, HIV prevention interventions.

  8. Emergent Gravity and the Dark Universe

    Directory of Open Access Journals (Sweden)

    Erik P. Verlinde

    2017-05-01

    Full Text Available Recent theoretical progress indicates that spacetime and gravity emerge together from the entanglement structure of an underlying microscopic theory. These ideas are best understood in Anti-de Sitter space, where they rely on the area law for entanglement entropy. The extension to de Sitter space requires taking into account the entropy and temperature associated with the cosmological horizon. Using insights from string theory, black hole physics and quantum information theory we argue that the positive dark energy leads to a thermal volume law contribution to the entropy that overtakes the area law precisely at the cosmological horizon. Due to the competition between area and volume law entanglement the microscopic de Sitter states do not thermalise at sub-Hubble scales: they exhibit memory effects in the form of an entropy displacement caused by matter. The emergent laws of gravity contain an additional 'dark' gravitational force describing the 'elastic' response due to the entropy displacement. We derive an estimate of the strength of this extra force in terms of the baryonic mass, Newton's constant and the Hubble acceleration scale a_0 =cH_0, and provide evidence for the fact that this additional `dark gravity~force' explains the observed phenomena in galaxies and clusters currently attributed to dark matter.

  9. 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...

  10. Priorities for emergency department syncope research

    NARCIS (Netherlands)

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

    2014-01-01

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

  11. Disentangling the Emerging Evidence around Atypical Fractures

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Clark, Emma M

    2012-01-01

    to radiology reports. The interests of the patients are probably best served by reserving long-term bisphosphonate treatment for patients who are at the highest risk of osteoporotic fractures and considering drug holidays after 5 years in patients at low risk. Recent studies have further strengthened the case...

  12. Nutraceuticals as natural healers: Emerging evidences

    African Journals Online (AJOL)

    STORAGESEVER

    2009-03-20

    Mar 20, 2009 ... African Journal of Biotechnology Vol. 8 (6) ... E.J. Research Institute of Chemistry, University of Karachi, ... components of fats are now postulated for their clinical manifestations, such as the sphingolipids as ... International acceptance and recognition of nutra- ..... Dr. Zafar Suhail Abbas, Mount Mercy Dental.

  13. Dollarization in emerging markets: evidence from Georgia

    Czech Academy of Sciences Publication Activity Database

    Loiseau-Aslanidi, Olga

    2012-01-01

    Roč. 48, č. 3 (2012), s. 70-84 ISSN 1540-496X Grant - others:UK(CZ) GAUK 259027 Institutional support: PRVOUK-P23 Keywords : dollarization * Georgia * money-in-utility function Subject RIV: AH - Economics Impact factor: 1.190, year: 2012

  14. Emergency preparedness in the future

    International Nuclear Information System (INIS)

    Desrosiers, A.E.

    1983-03-01

    This speech discusses safety issues facing nuclear power generation in terms of their contribution to increased costs of construction. The view is advanced that improvements in regulatory methods could be achieved by improvements in probabilistic risk assessment. The major deficiency in risk assessment is that the consequence assessments are not realistic and accident consequences not well understood. It is demonstrated that realistic modelling of evacuation times and other emergency preparedness capabilities can significantly reduce the calculated risk of operating nuclear power plants

  15. Emergency preparedness

    International Nuclear Information System (INIS)

    1997-01-01

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

  16. 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...

  17. Chemical Emergencies - Multiple Languages

    Science.gov (United States)

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

  18. Preparing for Emergency

    DEFF Research Database (Denmark)

    Melchiors, Jacob; Todsen, Tobias; Nilsson, Philip

    2015-01-01

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

  19. Emerging images

    KAUST Repository

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

    2009-01-01

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

  20. 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...

  1. 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.

  2. EMERGENCY CALLS

    CERN Multimedia

    Medical Service

    2001-01-01

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

  3. 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.

  4. Anorectal emergencies

    Science.gov (United States)

    Lohsiriwat, Varut

    2016-01-01

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

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

    Science.gov (United States)

    Pedigo, Ryan Anthony; Zaurova, Milana

    2017-06-22

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

  6. Hematologic emergencies

    Directory of Open Access Journals (Sweden)

    Daniele Vallisa

    2012-01-01

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

  7. 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.

  8. Emergency situations

    International Nuclear Information System (INIS)

    2007-01-01

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

  9. Emergency neuroradiology

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  10. EMERGENCY CONTRACEPTION

    Directory of Open Access Journals (Sweden)

    Dragana Pantić

    2007-10-01

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

  11. Nuclear emergencies

    International Nuclear Information System (INIS)

    1991-01-01

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

  12. EMERGING MARKETS

    Directory of Open Access Journals (Sweden)

    GHEORGHE CARALICEA-MĂRCULESCU

    2012-03-01

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

  13. Emergency radiology

    International Nuclear Information System (INIS)

    Keats, T.E.

    1986-01-01

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

  14. Socioeconomic deprivation and accident and emergency attendances

    DEFF Research Database (Denmark)

    Scantlebury, Rachel; Rowlands, Gillian; Durbaba, Stevo

    2015-01-01

    BACKGROUND: Demand for England's accident and emergency (A&E) services is increasing and is particularly concentrated in areas of high deprivation. The extent to which primary care services, relative to population characteristics, can impact on A&E is not fully understood. AIM: To conduct...

  15. Emergency Preparedness

    CERN Document Server

    2001-01-01

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

  16. Emerging Materiality

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  17. Emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-07-01

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

  18. OPERATION EMERGENCE.

    Science.gov (United States)

    MELBO, IRVING R.

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

  19. Emergent Behaviour

    NARCIS (Netherlands)

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

    2016-01-01

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

  20. 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...

  1. Thyroid emergencies.

    Science.gov (United States)

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

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

  2. 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.

  3. 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

  4. Emergency management

    International Nuclear Information System (INIS)

    1996-01-01

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

  5. 44 CFR 68.9 - Admissible evidence.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Admissible evidence. 68.9 Section 68.9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... admissible. (b) Documentary and oral evidence shall be admissible. (c) Admissibility of non-expert testimony...

  6. Yes Virginia, quantum mechanics can be understood

    CERN Document Server

    Wallace, John P

    2017-01-01

    Virginia, B. W. Wooster, and Jeeves take up physics with the hope of understanding quantum mechanics. In the process they take a rather grand tour on an old sailing ship and aid a sow in distress. On their journey they discover that physics is not as difficult a subject as they imagined. When they dismantled physics and reassembled it in a form where gravity, strong, electromagnetic and the weak forces all stem from understanding the gaming strategy known as the fair-game. That great cultural divide first expounded by the novelist C.P.Snow was found to be a mere ditch that can be stepped over. The sins of the past were violations of energy conservation and strange notions about what mass actually represents. Now mass is defined without the assistance of the Standard Model. Things will not be the same. Singularities have been banished. The electron now has a scale and is no longer captive in a point. The gluon is no longer essential along with the single virtual photon.

  7. Evil Understood as the Absence of Freedom

    DEFF Research Database (Denmark)

    Rabjerg, Bjørn

    2017-01-01

    Self-development is closely related to the idea of formation (or what is referred to as Bildung in German). But when speaking of formation, we have to address the question, ‘what are we formed by?’ Is the human being formed by him- or herself, or by resources originating from outside the self? Fr...

  8. The Center of Gravity, Systemically Understood

    Science.gov (United States)

    2013-05-23

    manner that gave him the time to pursue and destroy the retreating army. Centuries later, another great captain – Napoléon Bonaparte – employed...Jena-Auerstadt 1806 In 1806, Napoléon Bonaparte became the first operational artist in the history of modern war when he defeated the Prussian... Napoleon , Operational Art, and the Jena Campaign,” in Historical Perspectives of the Operational Art, ed. Michael D. Krause and R. Cody Phillips

  9. Emerging Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter

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

  10. 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...

  11. Emerging jets

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-15

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

  12. Emerging jets

    International Nuclear Information System (INIS)

    Schwaller, Pedro; Stolarski, Daniel

    2015-02-01

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

  13. Emergency preparedness

    International Nuclear Information System (INIS)

    1998-01-01

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

  14. Natural Fabrications Science, Emergence and Consciousness

    CERN Document Server

    Seager, William

    2012-01-01

    The spectacular success of the scientific enterprise over the last four hundred years has led to the promise of an all encompassing vision of the natural world. In this elegant picture, everything we observe is based upon just a few fundamental processes and entities. The almost infinite variety and complexity of the world is thus the product of emergence. But the concept of emergence is fraught with controversy and confusion. This book ponders the question of how emergence should be understood within the scientific picture, and whether a complete vision of the world can be attained that includes consciousness.

  15. Regional cooperation for emergency plan

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  16. Turn emergency generators into dollars

    International Nuclear Information System (INIS)

    Sheahen, T.P.; Stegen, G.R.

    1997-01-01

    The concept of distributed, dispatchable power generation is essentially the reverse of interruptible service. It can be understood by regarding both power and money as vectors: when the direction of the power flow switches, so does the direction of the money flow. At a signal given by the utility, a factory activates its emergency generating system and briefly becomes an independent power producer (IPP), feeding power into a local region of the grid. Upon receipt of another signal, it retires from that role. It may, however, continue to generate power for its own use

  17. Abdominal emergencies

    International Nuclear Information System (INIS)

    Raissaki, M.

    2012-01-01

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

  18. Being a Modern Human: essentialist and hierarchical approaches to the emergence of 'modern human behaviour'

    Directory of Open Access Journals (Sweden)

    Terry Hopkinson

    2013-06-01

    Full Text Available The emergence of the modern human mind and modern human behaviour is a prominent issue in palaeolithic archaeology. The consensus has been that modernity, understood in terms of increased rates of innovation and the emergence of symbolism, is enabled by a heritable neurophysiology unique to Homo sapiens. This consensus is characterised as biological essentialist in that it understands modernity as genotypically specified and unique to Homo sapiens. 'Archaic' hominins such as the Neanderthals are understood to have lacked the modern neuroanatomical genotype and therefore to have been innately incapable of modern cognition and behaviour. The biological-essentialist programme, however, is facing a serious challenge as evidence for innovation and symbolism is found in the archaeological records of the Eurasian Middle Palaeolithic and the African Middle Stone Age. An alternative programme is emerging that understands modern human behaviour as an emergent property of social, demographic and ecological dynamics. It is argued that this programme is currently inadequate since it cannot explain the emergence of symbolically charged material culture and relies on inexorable long-term population growth. It is suggested here that the problem is better understood in terms of hierarchy theory, a body of ideas concerned with systems organised on multiple scales. Palaeolithic behaviour is reconceptualised as social practice emerging from a multi-scale knowledge system. It is shown that enhancements in the rate at which knowledgeable practices disseminate through social fields – the social transmission of knowledge - will have the effect of increasing the likelihood that novel practices will be incorporated into long-term structuring principles and thus become persistent practices. They will also effect a scalar convergence of domains of knowledgeability such that technical practices become incorporated into the construction of personhood as meaningful or

  19. Biodosimetry: emergency preparedness

    International Nuclear Information System (INIS)

    Pradeepkumar, K.S.

    2016-01-01

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

  20. 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 ...

  1. [The evaluation of academic emergency department design].

    Science.gov (United States)

    Deniz, Turgut; Aydinuraz, Kuzey; Oktay, Cem; Saygun, Meral; Ağalar, Fatih

    2007-01-01

    In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated. In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed. Two Emergency Medicine Departments that were not operating at that time were not included in the study. The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academic efforts in this field is emerging in challenging physical conditions. The results of our study revealed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.

  2. Complex systems dynamics in aging: new evidence, continuing questions.

    Science.gov (United States)

    Cohen, Alan A

    2016-02-01

    There have long been suggestions that aging is tightly linked to the complex dynamics of the physiological systems that maintain homeostasis, and in particular to dysregulation of regulatory networks of molecules. This review synthesizes recent work that is starting to provide evidence for the importance of such complex systems dynamics in aging. There is now clear evidence that physiological dysregulation--the gradual breakdown in the capacity of complex regulatory networks to maintain homeostasis--is an emergent property of these regulatory networks, and that it plays an important role in aging. It can be measured simply using small numbers of biomarkers. Additionally, there are indications of the importance during aging of emergent physiological processes, functional processes that cannot be easily understood through clear metabolic pathways, but can nonetheless be precisely quantified and studied. The overall role of such complex systems dynamics in aging remains an important open question, and to understand it future studies will need to distinguish and integrate related aspects of aging research, including multi-factorial theories of aging, systems biology, bioinformatics, network approaches, robustness, and loss of complexity.

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

    Science.gov (United States)

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

    2015-07-01

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

  4. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

    OpenAIRE

    Langabeer, James R.; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

    2016-01-01

    Introduction Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. T...

  5. Contraceptive availability during an emergency response in the United States.

    Science.gov (United States)

    Ellington, Sascha R; Kourtis, Athena P; Curtis, Kathryn M; Tepper, Naomi; Gorman, Susan; Jamieson, Denise J; Zotti, Marianne; Barfield, Wanda

    2013-03-01

    This article provides the evidence for contraceptive need to prevent unintended pregnancy during an emergency response, discusses the most appropriate types of contraceptives for disaster situations, and details the current provisions in place to provide contraceptives during an emergency response.

  6. Responsibility modelling for civil emergency planning

    OpenAIRE

    Sommerville, Ian; Storer, Timothy; Lock, Russell

    2009-01-01

    This paper presents a new approach to analysing and understanding civil emergency planning based on the notion of responsibility modelling combined with HAZOPS-style analysis of information requirements. Our goal is to represent complex contingency plans so that they can be more readily understood, so that inconsistencies can be highlighted and vulnerabilities discovered. In this paper, we outline the framework for contingency planning in the United Kingdom and introduce the notion of respons...

  7. Chronic disruptive pain in emerging adults with and without chronic health conditions and the moderating role of psychiatric disorders: Evidence from a population-based cross-sectional survey in Canada.

    Science.gov (United States)

    Qadeer, Rana A; Shanahan, Lilly; Ferro, Mark A

    2017-10-01

    There has been a growth in the proportion of emerging adults vulnerable to pain-related sequelae of chronic health conditions (CHCs). Given the paucity of research during this important developmental period, this study investigated the association between CHCs and chronic disruptive pain among emerging adults and the extent to which psychiatric disorders moderate this association. Data come from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH). This cross-sectional survey included 5987 participants that were 15-30 years of age and self-reported their CHCs (n=2460, 41%) and the extent to which pain impacted daily functioning using items from the Health Utilities Index Mark 3 (HUI 3). Group comparisons between respondents with CHCs and healthy controls were made using chi-square tests. Odds ratios (OR) and 95% confidence intervals (CI) were computed from ordinal logistic regression models adjusting for sociodemographic covariates. Product-term interactions between CHCs and psychiatric disorders were included in the models to explore moderating effects. All analyses were weighted to maintain representativeness of the study sample to the Canadian population. The mean age of participants was 23.5 (SE 0.1) years and 48% were female. Compared to healthy controls, a greater proportion of participants with CHCs reported having chronic pain (20.3% vs. 4.5%, pmoderate the association between CHCs and chronic disruptive pain. Specifically, the probability of chronic disruptive pain was higher for emerging adults without CHCs and with alcohol or drug disorders; however, among participants with CHCs, probability was higher for those without these disorders. There is a robust association between CHCs and chronic disruptive pain. The moderating effects suggest that alcohol or drug disorders are especially harmful for emerging adults without CHCs and contribute to higher levels of chronic disruptive pain; however, among those with CHCs, alcohol and illicit drugs

  8. Emergency warning for people with disabilities.

    Science.gov (United States)

    Putkovich, Kenneth

    2013-01-01

    The intent of this article is to assess the current state of Emergency Warning capabilities in the United States and make recommendations on what needs to be done to cost effectively establish a National Emergency Warning System to best serve the people of the United States, including those with disabilities. As part of this assessment, terminology will be defined, existing systems will be examined, critical needs and functions will be explained, and recommendations made for a system to deliver emergency messages to those people immediately at risk from natural and human-caused disasters in a timely and effective manner, regardless of location or situational circumstance. The assessment will include the needs and available technologies for delivering emergency warnings to people with disabilities, which are generally little understood, poorly addressed, and often ignored.

  9. Genome of the carbapenemase-producing clinical isolate Elizabethkingia miricola EM_CHUV and comparative genomics with Elizabethkingia meningoseptica and Elizabethkingia anophelis: evidence for intrinsic multidrug resistance trait of emerging pathogens.

    OpenAIRE

    Opota, O.; Diene, S.M.; Bertelli, C.; Prod'hom, G.; Eckert, P.; Greub, G.

    2017-01-01

    Elizabethkingia miricola is a Gram-negative non-fermenting rod emerging as a life-threatening human pathogen. The multidrug-resistant (MDR) carbapenemase-producing clinical isolate E. miricola EM_CHUV was recovered in the setting of severe nosocomial pneumonia. In this study, the genome of E. miricola EM_CHUV was sequenced and a functional analysis was performed, including a comparative genomic study with Elizabethkingia meningoseptica and Elizabethkingia anophelis. The resistome of EM_CHUV r...

  10. Special Globelics session proposal on: Lessons learned for priority setting and indicators relevant to the impact of research programmes in Europe and Emerging Economies. An evidence-based debate between the research and the policy-shaping community

    Energy Technology Data Exchange (ETDEWEB)

    Caloghirou, Y.; Vonortas, N.

    2016-07-01

    The purpose of this session is to present a coherent set of papers offering useful insights on research priority setting processes/activities and indicators used to measure the impact of research and technology development programmes in Europe and Emerging Economies (Brazil, Chile, Peru and Russia). In particular, the first paper focuses on the research collaborative networks funded by the European Union during the past three decades and offers a comprehensive picture of science-industry collaboration in Europe by using network indicators and providing data on the characteristics and the innovative performance of young firms participating in these networks. The second paper presents three cases of non-traditional indicators for R&D funding agencies from emerging economies and aims at contributing to the discussions on the importance of employing suitable indicators that can complement classic STI indicators. The third paper seeks to provide a critical overview of the recent exercise in the evaluation of public research institutions in Russia. The session (180 min) aims at bringing together researchers from both developed and emerging countries as well as policy makers and will be divided into two parts . The first part will be devoted in papers’ presentation and the second one in papers’ discussion by invited policy experts and officials. (Author)

  11. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 3: In a penetrating chest wound is a three-sided dressing or a one-way chest seal better at preventing respiratory complications?

    Science.gov (United States)

    Walthall, Kirsten

    2012-04-01

    A short-cut review was carried out to establish whether the traditional three-sided dressing is better than a one-way chest seal at preventing the respiratory complications from penetrating chest trauma. Only one animal study, two guidelines and two case reports provided published evidence relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that there is very little evidence, but that the one-way seals may have practical advantages, particularly in the out-of-hospital setting.

  12. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  13. Interventions for emergency contraception.

    Science.gov (United States)

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

    2017-08-02

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

  14. Agricultural intensification, priming for persistence and the emergence of Nipah virus: a lethal bat-borne zoonosis.

    Science.gov (United States)

    Pulliam, Juliet R C; Epstein, Jonathan H; Dushoff, Jonathan; Rahman, Sohayati A; Bunning, Michel; Jamaluddin, Aziz A; Hyatt, Alex D; Field, Hume E; Dobson, Andrew P; Daszak, Peter

    2012-01-07

    Emerging zoonoses threaten global health, yet the processes by which they emerge are complex and poorly understood. Nipah virus (NiV) is an important threat owing to its broad host and geographical range, high case fatality, potential for human-to-human transmission and lack of effective prevention or therapies. Here, we investigate the origin of the first identified outbreak of NiV encephalitis in Malaysia and Singapore. We analyse data on livestock production from the index site (a commercial pig farm in Malaysia) prior to and during the outbreak, on Malaysian agricultural production, and from surveys of NiV's wildlife reservoir (flying foxes). Our analyses suggest that repeated introduction of NiV from wildlife changed infection dynamics in pigs. Initial viral introduction produced an explosive epizootic that drove itself to extinction but primed the population for enzootic persistence upon reintroduction of the virus. The resultant within-farm persistence permitted regional spread and increased the number of human infections. This study refutes an earlier hypothesis that anomalous El Niño Southern Oscillation-related climatic conditions drove emergence and suggests that priming for persistence drove the emergence of a novel zoonotic pathogen. Thus, we provide empirical evidence for a causative mechanism previously proposed as a precursor to widespread infection with H5N1 avian influenza and other emerging pathogens.

  15. On Evidence and Argument in Phenomenological Research | Walsh ...

    African Journals Online (AJOL)

    Set against a background of calls for evidence-based practice, this paper explores the role of evidence and argument in phenomenological research. Drawing on Smith's (1998) analysis of original argument, the author considers how evidence can be discerned, understood, and communicated, and the resulting kinds and ...

  16. The Emerging Physics of Consciousness

    CERN Document Server

    Tuszynski, Jack A

    2006-01-01

    Consciousness remains one of the major unsolved problems in science. How do the feelings and sensations making up conscious experience arise from the concerted actions of nerve cells and their associated synaptic and molecular processes? Can such feelings be explained by modern science, or is there an entirely different kind of explanation needed? And how can this seemingly intractable problem be approached experimentally? How do the operations of the conscious mind emerge out of the specific interactions involving billions of neurons? This book seeks answers to these questions on the underlying assumption that consciousness can be understood using the intellectual potential of modern physics and other sciences. There are a number of theories of consciousness, some based on classical physics while others require the use of quantum concepts. The latter ones have drawn criticism from the parts of the scientific establishment while simultaneously claiming that classical approaches are doomed to failure. The cont...

  17. Emergency Medical Services

    Science.gov (United States)

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

  18. Chemical Emergencies Overview

    Science.gov (United States)

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

  19. Household Chemical Emergencies

    Science.gov (United States)

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

  20. Emergency Contraception Website

    Science.gov (United States)

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

  1. How Lafd Cert May Be Understood as a Smart Practice: How it is Pioneering a Transition to Whole Community Cert and How it Can Serve as the Template for Cert Programs Nationally

    Science.gov (United States)

    2017-01-10

    United States as a framework for organizing citizens to be more prepared. Using an appreciative inquiry approach, this thesis investigated how LAFD...established the first Community Emergency Response Training (CERT) Program in the United States as a framework for organizing citizens to be more prepared...50 4. How Social Media Influences Volunteers ........................................53 5. The World Wide Web and LAFD CERT

  2. 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...

  3. 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

  4. Development of an amygdalocentric neurocircuitry-reactive aggression theoretical model of emergence delirium in posttraumatic stress disorder: an integrative literature review.

    Science.gov (United States)

    McLott, Jason; Jurecic, Jerry; Hemphill, Luke; Dunn, Karen S

    2013-10-01

    The purposes of this integrative literature review were to (1) present a synopsis of current literature describing posttraumatic stress disorder (PTSD), the amygdalocentric neurocircuitry, emergence delirium, reactive aggression, and the interaction of general anesthetics and the amygdalocentric neurocircuitry; (2) synthesize this evidence; and (3) develop a new theoretical model that can be tested in future research studies. Over the past decade, a dramatic rise in PTSD among veterans has been reported because of recent combat deployments. Modern anesthetics alter the function of the amygdalocentric neurocircuitry to produce amnesia and sedation. The etiology of emergence delirium is poorly understood, and the condition is uncommon outside the pediatric population. Emergence delirium among patients with PTSD, however, has been reported by military nurse anesthetists. To date, there have been no scientific studies conducted to identify the cause of emergence delirium in combat veterans with PTSD. This new theoretical model may explain why noxious stimuli at the time of emergence may stimulate the thalamus, leading to activation of an uninhibited amygdalocentric neurocircuitry. Because of the loss of top-down inhibition, the hyperactive amygdala then stimulates the hypothalamus, which is responsible for creating an increase in excitatory activity in the unconscious patient, resulting in emergence delirium.

  5. Emerging Multinational Companies and Strategic Fit

    DEFF Research Database (Denmark)

    Gammeltoft, Peter; Filatotchev, Igor; Hobdari, Bersant

    2012-01-01

    There is an increasing awareness in international business that institutional factors need to be better incorporated into the understanding of international investments decisions of multinational companies. This applies equally to outward foreign direct investment by emerging economy firms...... has been suggested in terms of integrating various theoretical frameworks however and developing a more holistic understanding of these new investment flows. In this Editorial we propose that outward FDI from emerging economies can be better understood by analyzing them within a broad institutional...... which considers flows of outward investment from emerging economies as framed by institutional pressures at the firm level towards achieving fit between the environment, strategies, structures, resources and practices of the firm. For the multinational firm this fit must be attained along multiple...

  6. Risk perception, experience, and objective risk: a cross-national study with European emergency survivors.

    Science.gov (United States)

    Knuth, Daniela; Kehl, Doris; Hulse, Lynn; Schmidt, Silke

    2014-07-01

    Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross-over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross-over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed. © 2013 Society for Risk Analysis.

  7. Participant association and emergent curriculum in a MOOC: can the community be the curriculum?

    Directory of Open Access Journals (Sweden)

    Frances Bell

    2016-07-01

    Full Text Available We investigated how participants associated with each other and developed community in a Massive Open Online Course (MOOC about Rhizomatic Learning (Rhizo14. We compared learner experiences in two social networking sites (SNSs, Facebook and Twitter. Our combination of thematic analysis of qualitative survey data with analysis of participant observation, activity data, archives and visualisation of SNS data enabled us to reach a deeper understanding of participant perspectives and explore SNS use. Community was present in the course title and understood differently by participants. In the absence of explanation or discussion about community early in the MOOC, a controversy between participants about course expectations emerged that created oppositional discourse. Fall off in activity in MOOCs is common and was evident in Rhizo14. As the course progressed, fewer participants were active in Facebook and some participants reported feelings of exclusion. Despite this, activity in Facebook increased overall. The top 10 most active participants were responsible for 47% of total activity. In the Rhizo14 MOOC, both community and curriculum were expected to emerge within the course. We suggest that there are tensions and even contradictions between ‘Community Is the Curriculum’ and Deleuze and Guattari's principles of the rhizome, mainly focussed on an absence of heterogeneity. These tensions may be exacerbated by SNSs that use algorithmic streams. We propose the use of networking approaches that enable negotiation and exchange to encourage heterogeneity rather than emergent definition of community.

  8. Evidence of emerging Griffiths singularity in La{sub 0.5} Sr{sub 0.5} MnO{sub 3} nanocrystalline probed by magnetization and electron paramagnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xiyuan [Department of Applied Physics, Nanjing University of Aeronautics and Astronautics, Nanjing 210016 (China); Fan, Jiyu, E-mail: jiyufan@nuaa.edu.cn [Department of Applied Physics, Nanjing University of Aeronautics and Astronautics, Nanjing 210016 (China); Xu, Lisa [Department of Applied Physics, Nanjing University of Aeronautics and Astronautics, Nanjing 210016 (China); Tong, Wei [High Magnetic Field Laboratory, Chinese Academy of Sciences, Hefei 230031 (China); Hu, Dazhi [Department of Applied Physics, Nanjing University of Aeronautics and Astronautics, Nanjing 210016 (China); He, Xun [College of Environmental Science and Engineering, Hunan University, Changsha 410082 (China); Zhang, Lei; Pi, Li; Zhang, Yuheng [High Magnetic Field Laboratory, Chinese Academy of Sciences, Hefei 230031 (China)

    2016-06-01

    We present an investigation of Griffiths singularity in La{sub 0.5} Sr{sub 0.5} MnO{sub 3} nanocrystalline by means of magnetic susceptibility and electron paramagnetic resonance (EPR). An unusual platform was found in paramagnetic region. Based on the analysis of EPR spectrum and magnetization variation across the whole temperature range of phase transition, we confirm it is due to the presence of Griffiths singularity rather than a superparamagnetic state in the nanocrystalline system. Such a singularity phase is constituted with some correlated ferromagnetic clusters which embed in paramagnetic matrix. Although they form ferromagnetic spin correlation, the system do not yield any spontaneous magnetization. According to core–shell model, the emergence of Griffiths singularity can be considered due to the presence of local ferromagnetic fluctuations originated from surface spin disorder as the sample size is confined to nanoscale. - Highlights: • Griffiths singularity rather than superparamagnetism occurs in La{sub 0.5}Sr{sub 0.5}MnO{sub 3} nanoparticals. • The sample’s size reduced to nanoscale results in the short-range ferromagnetic interaction. • The core-shell model is used to understand the formation of Griffiths phase in nanometer La{sub 0.5}Sr{sub 0.5}MnO{sub 3}.

  9. Evidence for possible biological advantages of the newly emerging HIV-1 circulating recombinant form from Malaysia - CRF33_01B in comparison to its progenitors - CRF01_AE and subtype B.

    Science.gov (United States)

    Lau, Katherine A; Wang, Bin; Miranda-Saksena, Monica; Boadle, Ross; Kamarulzaman, Adeeba; Ng, Kee-Peng; Saksena, Nitin K

    2010-04-01

    In Malaysia, co-circulation of CRF01_AE and subtype B has resulted in the emergence of the second generation derivative; CRF33_01B in approximately 20% of its HIV-1 infected individuals. Our objective was to identify possible biological advantages that CRF33_01B possesses over its progenitors. Biological and molecular comparisons of CRF33_01B against its parental subtypes clearly show that CRF33_01B replicated better in activated whole peripheral blood mononuclear cells (PBMCs) and CD4+ T-lymphocytes, but not monocyte-derived macrophages (MDMs). Also, its acquired fitness was greater than CRF01_AE but not subtype B. Moreover, CRF33_01B has higher rate of apoptotic cell death and syncytia induction compared to subtype B. These adaptive and survival abilities could have been acquired by CRF33_01B due to the incorporation of subtype B fragments into the gag-RT region of its full-length genome. Our studies confirm the previously held belief that HIV-1 strains may harbor enhanced biological fitness upon recombination. We therefore estimate a possible gradual replacement of the current predominance of CRF01_AE, as well as wider dissemination of CRF33_01B, together with the identification of other new CRF01_AE/B inter-subtype recombinants in Malaysia.

  10. 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.

  11. Evidence logics with relational evidence

    DEFF Research Database (Denmark)

    Baltag, Alexandru; Occhipinti, Andrés

    2017-01-01

    We introduce a family of logics for reasoning about relational evidence: evidence that involves an ordering of states in terms of their relative plausibility. We provide sound and complete axiomatizations for the logics. We also present several evidential actions and prove soundness...

  12. Emergency care of raptors.

    Science.gov (United States)

    Graham, Jennifer E; Heatley, J Jill

    2007-05-01

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

  13. Identifying barriers to emergency care services.

    Science.gov (United States)

    Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

    2012-01-01

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

  14. Tularemia in Germany—A Re-emerging Zoonosis

    Directory of Open Access Journals (Sweden)

    Mirko Faber

    2018-02-01

    Full Text Available Tularemia, also known as “rabbit fever,” is a zoonosis caused by the facultative intracellular, gram-negative bacterium Francisella tularensis. Infection occurs through contact with infected animals (often hares, arthropod vectors (such as ticks or deer flies, inhalation of contaminated dust or through contaminated food and water. In this review, we would like to provide an overview of the current epidemiological situation in Germany using published studies and case reports, an analysis of recent surveillance data and our own experience from the laboratory diagnostics, and investigation of cases. While in Germany tularemia is a rarely reported disease, there is evidence of recent re-emergence. We also describe some peculiarities that were observed in Germany, such as a broad genetic diversity, and a recently discovered new genus of Francisella and protracted or severe clinical courses of infections with the subspecies holarctica. Because tularemia is a zoonosis, we also touch upon the situation in the animal reservoir and one-health aspects of this disease. Apparently, many pieces of the puzzle need to be found and put into place before the complex interaction between wildlife, the environment and humans are fully understood. Funding for investigations into rare diseases is scarce. Therefore, combining efforts in several countries in the framework of international projects may be necessary to advance further our understanding of this serious but also scientifically interesting disease.

  15. Tularemia in Germany—A Re-emerging Zoonosis

    Science.gov (United States)

    Faber, Mirko; Heuner, Klaus; Jacob, Daniela; Grunow, Roland

    2018-01-01

    Tularemia, also known as “rabbit fever,” is a zoonosis caused by the facultative intracellular, gram-negative bacterium Francisella tularensis. Infection occurs through contact with infected animals (often hares), arthropod vectors (such as ticks or deer flies), inhalation of contaminated dust or through contaminated food and water. In this review, we would like to provide an overview of the current epidemiological situation in Germany using published studies and case reports, an analysis of recent surveillance data and our own experience from the laboratory diagnostics, and investigation of cases. While in Germany tularemia is a rarely reported disease, there is evidence of recent re-emergence. We also describe some peculiarities that were observed in Germany, such as a broad genetic diversity, and a recently discovered new genus of Francisella and protracted or severe clinical courses of infections with the subspecies holarctica. Because tularemia is a zoonosis, we also touch upon the situation in the animal reservoir and one-health aspects of this disease. Apparently, many pieces of the puzzle need to be found and put into place before the complex interaction between wildlife, the environment and humans are fully understood. Funding for investigations into rare diseases is scarce. Therefore, combining efforts in several countries in the framework of international projects may be necessary to advance further our understanding of this serious but also scientifically interesting disease. PMID:29503812

  16. Digital evidence

    Directory of Open Access Journals (Sweden)

    Lukić Tatjana

    2012-01-01

    Full Text Available Although computer makes human activities faster and easier, innovating and creating new forms of work and other kinds of activities, it also influenced the criminal activity. The development of information technology directly affects the development of computer forensics without which, it can not even imagine the discovering and proving the computer offences and apprehending the perpetrator. Information technology and computer forensic allows us to detect and prove the crimes committed by computer and capture the perpetrators. Computer forensics is a type of forensics which can be defined as a process of collecting, preserving, analyzing and presenting digital evidence in court proceedings. Bearing in mind, that combat against crime, in which computers appear as an asset or object of the offense, requires knowledge of digital evidence as well as specific rules and procedures, the author in this article specifically addresses the issues of digital evidence, forensic (computer investigation, specific rules and procedures for detecting, fixing and collecting digital evidence and use of this type of evidence in criminal proceedings. The author also delas with international standards regarding digital evidence and cyber-space investigation.

  17. Medical Emergencies in Goa

    Science.gov (United States)

    Saddichha, Sahoo; Saxena, Mukul Kumar

    2010-01-01

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

  18. Part I. Emergency workers

    International Nuclear Information System (INIS)

    2004-01-01

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

  19. Chapter No.9. Emergency planning

    International Nuclear Information System (INIS)

    2002-01-01

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

  20. Self-Definition as Resistance: Understanding Identities among LGBTQ Emerging Adults

    Science.gov (United States)

    Wagaman, M. Alex

    2016-01-01

    Scholars have questioned the relevance of existing identity categories and labels for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth and emerging adults. Little is understood, however, about the ways in which LGBTQ emerging adults perceive their own identities and self-define the aspects of themselves that are most relevant to who…

  1. Collaborative Educational Leadership: The Emergence of Human Interactional Sense-Making Process as a Complex System

    Science.gov (United States)

    Jäppinen, Aini-Kristiina

    2014-01-01

    The article aims at explicating the emergence of human interactional sense-making process within educational leadership as a complex system. The kind of leadership is understood as a holistic entity called collaborative leadership. There, sense-making emerges across interdependent domains, called attributes of collaborative leadership. The…

  2. Best practices in managing child and adolescent behavioral health emergencies.

    Science.gov (United States)

    Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M

    2018-01-01

    Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies.

  3. Killing fields; The epidemiological evidence

    Energy Technology Data Exchange (ETDEWEB)

    Best, Simon

    1990-02-01

    The threat posed by low frequency fields emerged initially because a researcher, looking for environmental factors in childhood leukaemia, observed a link between low voltage, high current power lines and disease occurrence. Cellular evidence now supports the findings but epidemiology still leads the argument. (43 references). (author).

  4. Emergencies and emergency planning in France

    International Nuclear Information System (INIS)

    Jammet, H.

    1986-01-01

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

  5. Nuclear emergency preparedness: national organisation

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  6. Nuclear emergency preparedness: national organisation

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  7. Emergency control; Kawalan kecemasan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1988-12-31

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

  8. Emergency care of reptiles.

    Science.gov (United States)

    Boyer, T H

    1998-09-01

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

  9. [Emerging noninfectious diseases].

    Science.gov (United States)

    Consiglio, Ezequiel

    2008-11-01

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

  10. 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...

  11. Emergency Nurses Association

    Science.gov (United States)

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

  12. Emerging connections between RNA and autophagy

    DEFF Research Database (Denmark)

    Frankel, Lisa B; Lubas, Michal; Lund, Anders H

    2017-01-01

    in yeast, plants and animals, reviewing the molecular mechanisms and biological importance in normal physiology, stress and disease. In addition, we explore emerging evidence of core autophagy regulation mediated by RNA-binding proteins and noncoding RNAs, and point to gaps in our current knowledge......Macroautophagy/autophagy is a key catabolic process, essential for maintaining cellular homeostasis and survival through the removal and recycling of unwanted cellular material. Emerging evidence has revealed intricate connections between the RNA and autophagy research fields. While a majority...... of the connection between RNA and autophagy. Finally, we discuss the pathological implications of RNA-protein aggregation, primarily in the context of neurodegenerative disease....

  13. Harwell emergency handbook

    International Nuclear Information System (INIS)

    1986-12-01

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

  14. Derivatives in emerging markets

    OpenAIRE

    Dubravko Mihaljek; Frank Packer

    2010-01-01

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

  15. Emergent universe with wormholes in massive gravity

    Science.gov (United States)

    Paul, B. C.; Majumdar, A. S.

    2018-03-01

    An emergent universe (EU) scenario is proposed to obtain a universe free from big-bang singularity. In this framework the present universe emerged from a static Einstein universe phase in the infinite past. A flat EU scenario is found to exist in Einstein’s gravity with a non-linear equation of state (EoS). It has been shown subsequently that a physically realistic EU model can be obtained considering cosmic fluid composed of interacting fluids with a non-linear equation of state. It results a viable cosmological model accommodating both early inflation and present accelerating phases. In the present paper, the origin of an initial static Einstein universe needed in the EU model is explored in a massive gravity theory which subsequently emerged to be a dynamically evolving universe. A new gravitational instanton solution in a flat universe is obtained in the massive gravity theory which is a dynamical wormhole that might play an important role in realizing the origin of the initial state of the emergent universe. The emergence of a Lorentzian universe from a Euclidean gravity is understood by a Wick rotation τ = i t . A universe with radiation at the beginning finally transits into the present observed universe with a non-linear EoS as the interactions among the fluids set in. Thus a viable flat EU scenario where the universe stretches back into time infinitely, with no big bang is permitted in a massive gravity.

  16. Successes and Challenges of Emerging Economy Multinationals

    DEFF Research Database (Denmark)

    Successes and Challenges of Emerging Economy Multinationals investigates a broad variety of cases presenting clear evidence of fast successful internationalization of emerging economy multinationals originating not only from big economic players such as China, India and Russia but also from other...... successfully internationalizing emerging countries, namely South Africa and Poland. In terms of size, the firms vary from huge multinational firms such as Huawei, Tata and Gazprom, to really small high technology firms. The in-depth analysis conducted in this book leads to the indication of numerous novel...

  17. Advertising emergency department wait times.

    Science.gov (United States)

    Weiner, Scott G

    2013-03-01

    Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised.

  18. Funding emergency care: Australian style.

    Science.gov (United States)

    Bell, Anthony; Crilly, Julia; Williams, Ged; Wylie, Kate; Toloo, Ghasem Sam; Burke, John; FitzGerald, Gerry

    2014-08-01

    The ongoing challenge for ED leaders is to remain abreast of system-wide changes that impact on the day-to-day management of their departments. Changes to the funding model creates another layer of complexity and this introductory paper serves as the beginning of a discussion about the way in which EDs are funded and how this can and will impact on business decisions, models of care and resource allocation within Australian EDs. Furthermore it is evident that any funding model today will mature and change with time, and moves are afoot to refine and contextualise ED funding over the medium term. This perspective seeks to provide a basis of understanding for our current and future funding arrangements in Australian EDs. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  19. Advertising Emergency Department Wait Times

    Science.gov (United States)

    Weiner, Scott G.

    2013-01-01

    Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised. PMID:23599836

  20. Advertising Emergency Department Wait Times

    Directory of Open Access Journals (Sweden)

    Scott G. Weiner

    2013-03-01

    Full Text Available Advertising emergency department (ED wait times has become a common practice in the UnitedStates. Proponents of this practice state that it is a powerful marketing strategy that can help steerpatients to the ED. Opponents worry about the risk to the public health that arises from a patient withan emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standarddefinition of the reported time, and directing lower acuity patients to the higher cost ED setting insteadto primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times arediscussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects tothe public health, caution about its use is advised

  1. [Emergent viral infections

    NARCIS (Netherlands)

    Galama, J.M.D.

    2001-01-01

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

  2. Emergency preparedness in Finland

    International Nuclear Information System (INIS)

    Koivukoski, J.

    1993-01-01

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

  3. 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.

  4. Neurologic emergencies in sports.

    Science.gov (United States)

    Williams, Vernon B

    2014-12-01

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

  5. Common pitfalls in statistical analysis: "No evidence of effect" versus "evidence of no effect"

    Directory of Open Access Journals (Sweden)

    Priya Ranganathan

    2015-01-01

    Full Text Available This article is the first in a series exploring common pitfalls in statistical analysis in biomedical research. The power of a clinical trial is the ability to find a difference between treatments, where such a difference exists. At the end of the study, the lack of difference between treatments does not mean that the treatments can be considered equivalent. The distinction between "no evidence of effect" and "evidence of no effect" needs to be understood.

  6. The nuclear emergency plans

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  7. Sustainability dilemmas in emerging economies

    Directory of Open Access Journals (Sweden)

    Rama K. Jayanti

    2014-06-01

    Full Text Available Increasing evidence of climate change is forcing businesses to play an active role in reducing sustainability burdens and preserving resources for future generations. Extant research on sustainability has an exclusive focus on developed countries with stringent environmental regulations and activist scrutiny. Emerging markets present interesting dilemmas since rapid mass urbanisation aimed at raising standards of living poses concomitant threats to environmental health. This round table aimed to showcase best practices in sustainability within the Indian business context. Insights from the discussion regarding sustainability dilemmas provide a fertile ground for bench marking global sustainability best practices.

  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. Design Methods in the Emergent City

    DEFF Research Database (Denmark)

    Samson, Kristine

    The paper seeks to define urban design in relation to the specific challenges of emerging cities. Through a case study of Mudo Coletivos temporary structure, Bolha Imobiliaria, and the making of it, I wish to outline a design approach for urban design in cities lacking public spaces. Urban design...... is understood in a broad sense, not as architectural design but as spatial design and artistic interventions in public space. Through the paper I will address how the designer can co-create and reassemble existing urban spaces through design acts. The approach suggests a situated design methodology but is based...... on a theoretical understanding. It is my belief that the designer, by looking into the emergent properties of urban spaces, instead of its physical and cartographical outlines, can see her work as a processual intervention in the city rather than durable object design....

  10. 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.

  11. Update on emergency contraception.

    Science.gov (United States)

    Fok, Wing Kay; Blumenthal, Paul D

    2016-12-01

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

  12. [Oncological emergencies in the emergency department].

    Science.gov (United States)

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

    2011-01-01

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

  13. 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.>.

  14. Defining an emerging disease.

    Science.gov (United States)

    Moutou, F; Pastoret, P-P

    2015-04-01

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

  15. Nível do câmbio e crescimento econômico: teorias e evidências para países em desenvolvimento e emergentes Exchange rate levels and economic growth: theoretical analysis and empirical evidence for developing and emerging countries

    Directory of Open Access Journals (Sweden)

    Eliane Cristina de Araújo

    2010-12-01

    Full Text Available O artigo analisa, teórica e empiricamente, a relação entre nível da taxa de câmbio e crescimento econômico nos países em desenvolvimento. Inicialmente, os objetivos da política cambial são discutidos, enfatizando sua importância como instrumento gerador de crescimento econômico. Dando continuidade, alguns canais de influência do nível da taxa de câmbio sobre o crescimento econômico são apontados: (i os canais do investimento; (ii da exportação dos bens não tradicionais; (iii do desempenho do setor de bens comercializáveis; (iv da compensação às falhas de mercado e falhas contratuais; e (v de estímulo às elasticidades-renda das exportações. Na parte empírica, uma medida de subvalorização cambial é construí-da para 82 países em desenvolvimento entre 1980 e 2007. Essa medida é empregada para captar a relação entre taxa de câmbio desvalorizada e crescimento econômico. Os resultados indicam uma correlação positiva e significante entre a medida de subvalorização cambial construída e o crescimento econômico nos países que fazem parte da amostra.The article analyses, theoretically and empirically, the relationship between exchange rate level and economic growth in emerging and developing countries. Firstly, the exchange rate policy objectives are discussed, emphasizing the importance of this policy to generate economic growth. Continuing, the article explores the channels through which exchange rates can affect economic growth, highlighting its stimulus to investment, export of non-traditional goods, productivity as well as its compensation to market failures and its stimulus to export income-elasticity. In the empirical part, a measure of exchange rate undervaluation based on Rodrik (2007 is built for 82 emerging and developing countries, between 1980 and 2007. This measure is used to investigate the relationship between devalued exchange rate and economic growth, by econometric techniques for panel data

  16. Voltage Imaging of Waking Mouse Cortex Reveals Emergence of Critical Neuronal Dynamics

    Science.gov (United States)

    Scott, Gregory; Fagerholm, Erik D.; Mutoh, Hiroki; Leech, Robert; Sharp, David J.; Shew, Woodrow L.

    2014-01-01

    Complex cognitive processes require neuronal activity to be coordinated across multiple scales, ranging from local microcircuits to cortex-wide networks. However, multiscale cortical dynamics are not well understood because few experimental approaches have provided sufficient support for hypotheses involving multiscale interactions. To address these limitations, we used, in experiments involving mice, genetically encoded voltage indicator imaging, which measures cortex-wide electrical activity at high spatiotemporal resolution. Here we show that, as mice recovered from anesthesia, scale-invariant spatiotemporal patterns of neuronal activity gradually emerge. We show for the first time that this scale-invariant activity spans four orders of magnitude in awake mice. In contrast, we found that the cortical dynamics of anesthetized mice were not scale invariant. Our results bridge empirical evidence from disparate scales and support theoretical predictions that the awake cortex operates in a dynamical regime known as criticality. The criticality hypothesis predicts that small-scale cortical dynamics are governed by the same principles as those governing larger-scale dynamics. Importantly, these scale-invariant principles also optimize certain aspects of information processing. Our results suggest that during the emergence from anesthesia, criticality arises as information processing demands increase. We expect that, as measurement tools advance toward larger scales and greater resolution, the multiscale framework offered by criticality will continue to provide quantitative predictions and insight on how neurons, microcircuits, and large-scale networks are dynamically coordinated in the brain. PMID:25505314

  17. Virtually Nursing: Emerging Technologies in Nursing Education.

    Science.gov (United States)

    Foronda, Cynthia L; Alfes, Celeste M; Dev, Parvati; Kleinheksel, A J; Nelson, Douglas A; OʼDonnell, John M; Samosky, Joseph T

    Augmented reality and virtual simulation technologies in nursing education are burgeoning. Preliminary evidence suggests that these innovative pedagogical approaches are effective. The aim of this article is to present 6 newly emerged products and systems that may improve nursing education. Technologies may present opportunities to improve teaching efforts, better engage students, and transform nursing education.

  18. Psychiatric service users' experiences of emergency departments

    DEFF Research Database (Denmark)

    Carstensen, Kathrine; Lou, Stina; Jensen, Lotte Groth

    2017-01-01

    Background: There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users’ experiences regarding general EDs is limited. Aim: To identify and summarize current, qualitative evidence rega...... the discomfort. Overall, the results of this review speak in favour of integrated EDs where service users’ needs are more likely to be recognized and accommodated....

  19. Emergency department management of priapism [digest].

    Science.gov (United States)

    Podolej, Gregory S; Babcock, Christine; Kim, Jeremy

    2017-01-22

    Priapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. The diagnosis of ischemic priapism relies heavily on the history and physical examination and may be facilitated by penile blood gas analysis and penile ultrasound. This issue reviews current evidence regarding emergency department treatment of ischemic priapism using a stepwise approach that begins with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents. Evidence-based management and appropriate urologic follow-up of nonischemic and recurrent ischemic priapism maximizes patient outcomes and resource utilization. [Points & Pearls is a digest of Emergency Medicine Practice].

  20. 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.

  1. Nonneurologic emergencies in boxing.

    Science.gov (United States)

    Coletta, Domenic F

    2009-10-01

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

  2. Household Expenditures on Private Tutoring: Emerging Evidence from Malaysia

    Science.gov (United States)

    Kenayathulla, Husaina Banu

    2013-01-01

    Private tutoring has been a burgeoning phenomenon in Malaysia for decades. This study examines the determinants of private tutoring expenditures in Malaysia using the 2004/2005 Household Expenditures Survey and applies hurdle regression models to the data. The results indicate that total household expenditures, household head's level of education,…

  3. Bilinguals' Creativity and Syntactic Theory: Evidence for Emerging Grammar.

    Science.gov (United States)

    Bhatia, Tej K.

    1989-01-01

    Examines a code mixed variety of English and Hindi called Filmi English, which reflects the linguistic influence of the Indian film industry. A corpus of more than 2,000 intrasentential code-mixed sentences drawn from a film magazine, "Stardust," is analyzed. (Author/OD)

  4. Nutraceuticals as natural healers: Emerging evidences | Ali | African ...

    African Journals Online (AJOL)

    The protective effects of tocotrienols in flax seed oil, the curcuminoids in turmeric, carotenoids in carrots, flavonoids in fruits/vegetables, omega-3 fatty acids in sea foods, allyl-sulfides in garlic and -glucans in mush-rooms/cereals are few common examples to be cited here. Excess saturated fat is attributed to pose adverse ...

  5. 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,...

  6. Inspection of Emergency Arrangements

    International Nuclear Information System (INIS)

    2013-01-01

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

  7. Radiation monitoring strategy in nuclear or radiological emergencies

    International Nuclear Information System (INIS)

    Lahtinen, J.

    2003-01-01

    Full text: Radiation measurements provide indispensable data needed for the management of a nuclear or radiological emergency. There must exist pre-prepared emergency monitoring strategies, with accompanying procedures and methods, that help the authorities to perform measurements efficiently and, consequently, to evaluate the radiological situation correctly and to carry out proper countermeasures on time. However, defining a realistic yet comprehensive radiation monitoring strategy for emergencies is far from being an easy task. The very concept of 'emergency monitoring strategy' should be understood in a broad sense. In an ideal case, a strategy has interfaces with all related emergency and information exchange arrangements and agreements both at the national and international level. It covers all activities from the recognition of a potential hazard situation to environmental sampling performed during the late phases of an accident. It integrates routine-monitoring practices with the special requirements set by emergency monitoring and the use of fixed monitoring stations with that of mobile measurement teams. It includes elements for gathering, analyzing, transmitting and presenting data, as well as for combining them with different kinds of forecasts. It also takes into account the various intrinsic characteristics of possible threat scenarios and contains options for adapting measuring activities according to prevailing environmental conditions. Furthermore, a strategy must have relevant links to the social and economical realities and to the primary interests of different stakeholders. In order to assist individual countries in establishing national strategies, international organisations (IAEA, OECD/NEA, EU) have published basic guidelines for emergency response and radiation measurements. Nuclear accidents, especially the Chernobyl case with its large-scale environmental consequences, and other kinds of shocking events (like the one on September 11, 2001

  8. The relationship between emergence from spawning gravel and growth in farmed rainbow trout Oncorhynchus mykiss

    DEFF Research Database (Denmark)

    Åberg Andersson, Madelene; Laursen, Danielle Caroline; SILVA, P.I.M.

    2013-01-01

    The relationship between the timing of emergence from spawning gravel and growth after emergence was investigated in farmed Oncorhynchus mykiss. A relationship between the time of emergence and growth became evident after 6 months of rearing, where individuals with an intermediate emergence time...

  9. 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

  10. Intuition in emergency nursing: a phenomenological study.

    Science.gov (United States)

    Lyneham, Joy; Parkinson, Camillus; Denholm, Carey

    2008-04-01

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

  11. Fermions in noncommutative emergent gravity

    International Nuclear Information System (INIS)

    Klammer, D.

    2010-01-01

    Noncommutative emergent gravity is a novel framework disclosing how gravity is contained naturally in noncommutative gauge theory formulated as a matrix model. It describes a dynamical space-time which itself is a four-dimensional brane embedded in a higher-dimensional space. In noncommutative emergent gravity, the metric is not a fundamental object of the model; rather it is determined by the Poisson structure and by the induced metric of the embedding. In this work the coupling of fermions to these matrix models is studied from the point of view of noncommutative emergent gravity. The matrix Dirac operator as given by the IKKT matrix model defines an appropriate coupling for fermions to an effective gravitational metric of noncommutative four-dimensional spaces that are embedded into a ten-dimensional ambient space. As it turns out this coupling is non-standard due to a spin connection that vanishes in the preferred but unobservable coordinates defined by the model. The purpose of this work is to study the one-loop effective action of this approach. Standard results of the literature cannot be applied due to this special coupling of the fermions. However, integrating out these fields in a nontrivial geometrical background induces indeed the Einstein-Hilbert action of the effective metric, as well as additional terms which couple the noncommutative structure to the Riemann tensor, and a dilaton-like term. It remains to be understood what the effects of these terms are and whether they can be avoided. In a second step, the existence of a duality between noncommutative gauge theory and gravity which explains the phenomenon of UV/IR mixing as a gravitational effect is discussed. We show how the gravitational coupling of fermions can be interpreted as a coupling of fermions to gauge fields, which suffers then from UV/IR mixing. This explanation does not render the model finite but it reveals why some UV/IR mixing remains even in supersymmetric models, except in the N

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

    Science.gov (United States)

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

    2018-04-01

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

  13. 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...

  14. Emergency exercise scenario tools

    International Nuclear Information System (INIS)

    Sjoeblom, K.

    1998-03-01

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

  15. Theme: Emerging Technologies.

    Science.gov (United States)

    Malpiedi, Barbara J.; And Others

    1989-01-01

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

  16. 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.

  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. Competitiveness in Emerging Markets

    DEFF Research Database (Denmark)

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

  19. Radiology in emergency medicine

    International Nuclear Information System (INIS)

    Levy, R.; Barsan, W.G.

    1986-01-01

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

  20. 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....

  1. Electrophysiological evidence for phenomenal consciousness.

    Science.gov (United States)

    Revonsuo, Antti; Koivisto, Mika

    2010-09-01

    Abstract Recent evidence from event-related brain potentials (ERPs) lends support to two central theses in Lamme's theory. The earliest ERP correlate of visual consciousness appears over posterior visual cortex around 100-200 ms after stimulus onset. Its scalp topography and time window are consistent with recurrent processing in the visual cortex. This electrophysiological correlate of visual consciousness is mostly independent of later ERPs reflecting selective attention and working memory functions. Overall, the ERP evidence supports the view that phenomenal consciousness of a visual stimulus emerges earlier than access consciousness, and that attention and awareness are served by distinct neural processes.

  2. Educational program emergency planning.

    Science.gov (United States)

    Curtis, Tammy

    2009-01-01

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

  3. Management of Radiological emergencies

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  5. Practice Bulletin Summary No. 152: Emergency Contraception.

    Science.gov (United States)

    2015-09-01

    Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (1-3). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (4-6). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

  6. Practice Bulletin No. 152: Emergency Contraception.

    Science.gov (United States)

    2015-09-01

    Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

  7. Training for emergency management

    International Nuclear Information System (INIS)

    Grauf, E.

    1993-01-01

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

  8. 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.

  9. Leader emergence through interpersonal neural synchronization.

    Science.gov (United States)

    Jiang, Jing; Chen, Chuansheng; Dai, Bohan; Shi, Guang; Ding, Guosheng; Liu, Li; Lu, Chunming

    2015-04-07

    The neural mechanism of leader emergence is not well understood. This study investigated (i) whether interpersonal neural synchronization (INS) plays an important role in leader emergence, and (ii) whether INS and leader emergence are associated with the frequency or the quality of communications. Eleven three-member groups were asked to perform a leaderless group discussion (LGD) task, and their brain activities were recorded via functional near infrared spectroscopy (fNIRS)-based hyperscanning. Video recordings of the discussions were coded for leadership and communication. Results showed that the INS for the leader-follower (LF) pairs was higher than that for the follower-follower (FF) pairs in the left temporo-parietal junction (TPJ), an area important for social mentalizing. Although communication frequency was higher for the LF pairs than for the FF pairs, the frequency of leader-initiated and follower-initiated communication did not differ significantly. Moreover, INS for the LF pairs was significantly higher during leader-initiated communication than during follower-initiated communications. In addition, INS for the LF pairs during leader-initiated communication was significantly correlated with the leaders' communication skills and competence, but not their communication frequency. Finally, leadership could be successfully predicted based on INS as well as communication frequency early during the LGD (before half a minute into the task). In sum, this study found that leader emergence was characterized by high-level neural synchronization between the leader and followers and that the quality, rather than the frequency, of communications was associated with synchronization. These results suggest that leaders emerge because they are able to say the right things at the right time.

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

    Science.gov (United States)

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

    2017-11-01

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

  11. Create an Emergency Kit

    Science.gov (United States)

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

  12. Winter Weather Emergencies

    Science.gov (United States)

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

  13. 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....

  14. 7. Emergency contraception

    African Journals Online (AJOL)

    Sitwala

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

  15. 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.

  16. Emergency management at sea

    International Nuclear Information System (INIS)

    Bockholts, I.P.

    1992-01-01

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

  17. Emerging Targets in Photopharmacology

    NARCIS (Netherlands)

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

    2016-01-01

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

  18. Transboundary and Emerging Diseases

    NARCIS (Netherlands)

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

    2013-01-01

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

  19. 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:...

  20. Imaging of gynecologic emergencies

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  1. 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...

  2. Football emergency medicine

    African Journals Online (AJOL)

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

  3. Emerging nuclear suppliers

    International Nuclear Information System (INIS)

    Sands, A.

    1990-01-01

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

  4. Blog and Podcast Watch: Cutaneous Emergencies

    Directory of Open Access Journals (Sweden)

    Andrew Grock

    2017-02-01

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

  5. Transfusion Related Emergencies

    OpenAIRE

    Osborn, Megan Boysen; Tran, Min-Ha

    2016-01-01

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

  6. Ten Questions about Emergence

    OpenAIRE

    Fromm, Jochen

    2005-01-01

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

  7. Diabetic and endocrine emergencies

    OpenAIRE

    Kearney, T; Dang, C

    2007-01-01

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

  8. Design of emergency shield

    International Nuclear Information System (INIS)

    Soliman, S.E.

    1993-01-01

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

  9. Emergency response workers workshop

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  10. Planning for nuclear emergencies

    International Nuclear Information System (INIS)

    Lakey, J.R.A.

    1989-01-01

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

  11. Emerging technologies in surgery

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  12. Industrial emerging chemicals in the environment

    Directory of Open Access Journals (Sweden)

    Vojinović-Miloradov Mirjana B.

    2014-01-01

    Full Text Available In the recent time, considerable interest has grown concerning the presence of the emerging industrial chemicals, EmIC. They are contaminants that have possible pathway to enter to the environment and they are dominantly released by industrial and anthropogenic activities. EmIC are applied in different fields using as industrial chemicals (new and recently recognized, global organic contaminants (flame retardant chemicals, pharmaceuticals (for both human and animal uses, endocrine-modulating compounds, biological metabolites, personal care products, household chemicals, nanomaterial (energy storage products, lubricants, anticorrosive and agriculture chemicals and others that are applied to a wide variety of everyday items such as clothing, upholstery, electronics and automobile interiors. NORMAN (Network of reference laboratories for monitoring of emerging environmental pollutants has established an open, dynamic, list of emerging substances and pollutants. EmIC have been recently detected in the environment due to their long-term presence, pseudo-persistence and increased use. Improvements in sophisticated analytical methods and time integrative passive sampling have enabled the identification and quantification of EmIC, in very low concentrations (ppb, ppt and lower, which likely have been present in all environmental mediums for decades. Passive technology is an innovative technique for the time-integrated measurement of emerging contaminants in water, sediment, soil and air. Passive samplers are simple handling cost-effective tool that could be used in environmental monitoring programmes. These devices are now being considered as a part of an emerging strategy for monitoring a range of emerging industrial chemicals and priority pollutants in the aquatic environment. EmIC are substances that are not included in the routine monitoring programmes and whose fate, behaviour and (ecotoxicological effects are still not well understood. Emerging

  13. Accident and emergency management

    International Nuclear Information System (INIS)

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

    1988-06-01

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

  14. Emerging zoonotic viral diseases.

    Science.gov (United States)

    Wang, L-F; Crameri, G

    2014-08-01

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

  15. Emergency reactor cooling device

    International Nuclear Information System (INIS)

    Arakawa, Ken.

    1993-01-01

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

  16. Studying the emerging nuclear suppliers

    International Nuclear Information System (INIS)

    Rydell, R.F.

    1990-01-01

    None of these events---nor any of the many others that are cited in the case studies of this book---can be singled out as heralding a revolutionary transformation of the global nuclear marketplace. The cumulative effect of such developments, however, may well be the emergence of a market in the year 2000 that is far less concentrated than today's market for nuclear reactors and fuel cycle technology. If this gradual structural transformation is accompanied by the entry into the market of new buyers and sellers that do not accept the Nuclear Non-Proliferation Treaty (NPT), safeguards administered by the IAEA, or other international norms directed at preventing the spread of nuclear weapon capabilities, the result may indeed have revolutionary dimensions for the business, diplomacy, and research of nuclear energy. A similar outcome could arise even f these norms are widely accepted but are not matched by an increase in the resources available to national governments and key international agencies that implement these norms. This paper identifies some of the pitfalls that researchers often encounter in researching the emerging suppliers and will outline some basic ground rules to guide the collection and interpretation of empirical evidence on supplier behavior

  17. Child Abuse: The Value of Systematic Screening at Emergency Rooms

    NARCIS (Netherlands)

    Sittig, J.S.

    2015-01-01

    There is no conclusive evidence that diagnostic tools detect physical child abuse among children coming to emergency rooms (ERs), but his evidence is urgently needed because both false-positive and false-negative diagnoses have serious adverse effects. This thesis describes several aspects of the

  18. Lung tissue mechanics as an emergent phenomenon.

    Science.gov (United States)

    Suki, Béla; Bates, Jason H T

    2011-04-01

    The mechanical properties of lung parenchymal tissue are both elastic and dissipative, as well as being highly nonlinear. These properties cannot be fully understood, however, in terms of the individual constituents of the tissue. Rather, the mechanical behavior of lung tissue emerges as a macroscopic phenomenon from the interactions of its microscopic components in a way that is neither intuitive nor easily understood. In this review, we first consider the quasi-static mechanical behavior of lung tissue and discuss computational models that show how smooth nonlinear stress-strain behavior can arise through a percolation-like process in which the sequential recruitment of collagen fibers with increasing strain causes them to progressively take over the load-bearing role from elastin. We also show how the concept of percolation can be used to link the pathologic progression of parenchymal disease at the micro scale to physiological symptoms at the macro scale. We then examine the dynamic mechanical behavior of lung tissue, which invokes the notion of tissue resistance. Although usually modeled phenomenologically in terms of collections of springs and dashpots, lung tissue viscoelasticity again can be seen to reflect various types of complex dynamic interactions at the molecular level. Finally, we discuss the inevitability of why lung tissue mechanics need to be complex.

  19. Urine Collection in the Emergency Department: What Really Happens in There?

    Directory of Open Access Journals (Sweden)

    Harrison Alter

    2012-12-01

    Full Text Available Introduction: In women with suspected urinary tract infection (UTI, a non-contaminated voidedspecimen is considered important for valid urinalysis and culture results. We assess whethermidstream parted-labia catch (MSPC instructions were provided by nurses, understood, andperformed correctly, according to the patient.Methods: We conducted a cross-sectional survey of English- and Spanish-speaking female patientssubmitting voided urine samples for urinalysis for suspected UTI. The survey was conducted in apublic teaching hospital emergency department (ED from June to December 2010, beginning 2months after development and dissemination of a nursing MSPC instructions protocol. Researchassistants administered the survey within 2 hours of urine collection. Nurses were unaware of thestudy purpose.Results: Of 129 patients approached, 74 (57% consented and were included in the analysis.Median age was 35; 44% were Latino. Regarding instructions from nurses, patients reported thefollowing: 45 (61%; 95% CI 50-72% received any instructions; of whom 37 (82%; 95% CI 71-93%understood them completely. Sixteen (36%; 95% CI 22-51% were instructed to collect midstream;and 7 (16%; 95% CI 6-29% to part the labia. Regardless of receiving or understanding instructions,33 (45%; 95% CI 33-57% reported actually collecting midstream, and 11 (15%, 95% CI 8-25%parting the labia.Conclusion: In this ED, instructions for MSPC urine collection frequently were not given, despite anursing protocol, and patients rarely performed the essential steps. An evidence-based approachto urine testing in the ED that considers urine collection technique, is needed.

  20. Learning Outcomes of 'Understanding Research' as understood by ...

    African Journals Online (AJOL)

    Simon Bhekumuzi

    vision) for using Turnitin as a deterrent, in order to help learners to learn in the process. .... such as the American Psychological Association. (APA) ..... from other people. ..... and enduring concerns (2nd ed). ... Generations: The history of.

  1. How Self-Reliance Is Understood: Viewpoints from One Local ...

    African Journals Online (AJOL)

    DrNneka

    intervention makes it easy to see why there is less commitment to ... funding for countries where crisis' stretch government ability to respond ... National agencies such as DfID (UK), Norad (Norway), USAID (USA) and GIZ .... This case study uses a qualitative research design consistent with DiCicco- ..... Swedish International.

  2. English in Dutch commercials: Not understood and not appreciated

    NARCIS (Netherlands)

    Gerritsen, M.; Korzilius, H.P.L.M.; Meurs, W.F.J. van; Gijsbers, I.

    2000-01-01

    Dutch consumers are increasingly exposed to English in commercials on television. Advertising agencies appear to use English because of financial and image reasons. This article investigates how often commercials that contain English occur in the Netherlands and whether consumers comprehend the

  3. Q Fever: An Old but Still a Poorly Understood Disease

    Directory of Open Access Journals (Sweden)

    Hamidreza Honarmand

    2012-01-01

    Full Text Available Q fever is a bacterial infection affecting mainly the lungs, liver, and heart. It is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks. Infected animals shed this bacteria in birth products, feces, milk, and urine. Humans usually get Q fever by breathing in contaminated droplets released by infected animals and drinking raw milk. People at highest risk for this infection are farmers, laboratory workers, sheep and dairy workers, and veterinarians. Chronic Q fever develops in people who have been infected for more than 6 months. It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported. Symptoms of acute Q fever may include: chest pain with breathing, cough, fever, headache, jaundice, muscle pains, and shortness of breath. Symptoms of chronic Q fever may include chills, fatigue, night sweats, prolonged fever, and shortness of breath. Q fever is diagnosed with a blood antibody test. The main treatment for the disease is with antibiotics. For acute Q fever, doxycycline is recommended. For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used long term. Complications are cirrhosis, hepatitis, encephalitis, endocarditis, pericarditis, myocarditis, interstitial pulmonary fibrosis, meningitis, and pneumonia. People at risk should always: carefully dispose of animal products that may be infected, disinfect any contaminated areas, and thoroughly wash their hands. Pasteurizing milk can also help prevent Q fever.

  4. Default options in the ICU: widely used but insufficiently understood

    Science.gov (United States)

    Hart, Joanna; Halpern, Scott D.

    2015-01-01

    Purpose of review Default options dramatically influence the behavior of decision makers and may serve as effective decision support tools in the ICU. Their use in medicine has increased in an effort to improve efficiency, reduce errors, and harness the potential of healthcare technology. Recent findings Defaults often fall short of their predicted influence when employed in critical care settings as quality improvement interventions. Investigations reporting the use of defaults are often limited by variations in the relative effect across sites. Preimplementation experiments and long-term monitoring studies are lacking. Summary Defaults in the ICU may help or harm patients and clinical efficiency depending on their format and use. When constructing and encountering defaults, providers should be aware of their powerful and complex influences on decision making. Additional evaluations of the appropriate creation of healthcare defaults and their resulting intended and unintended consequences are needed. PMID:25203352

  5. Emotions are understood from biological motion across remote cultures.

    Science.gov (United States)

    Parkinson, Carolyn; Walker, Trent T; Memmi, Sarah; Wheatley, Thalia

    2017-04-01

    Patterns of bodily movement can be used to signal a wide variety of information, including emotional states. Are these signals reliant on culturally learned cues or are they intelligible across individuals lacking exposure to a common culture? To find out, we traveled to a remote Kreung village in Ratanakiri, Cambodia. First, we recorded Kreung portrayals of 5 emotions through bodily movement. These videos were later shown to American participants, who matched the videos with appropriate emotional labels with above chance accuracy (Study 1). The Kreung also viewed Western point-light displays of emotions. After each display, they were asked to either freely describe what was being expressed (Study 2) or choose from 5 predetermined response options (Study 3). Across these studies, Kreung participants recognized Western point-light displays of anger, fear, happiness, sadness, and pride with above chance accuracy. Kreung raters were not above chance in deciphering an American point-light display depicting love, suggesting that recognizing love may rely, at least in part, on culturally specific cues or modalities other than bodily movement. In addition, multidimensional scaling of the patterns of nonverbal behavior associated with each emotion in each culture suggested that similar patterns of nonverbal behavior are used to convey the same emotions across cultures. The considerable cross-cultural intelligibility observed across these studies suggests that the communication of emotion through movement is largely shaped by aspects of physiology and the environment shared by all humans, irrespective of differences in cultural context. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Well Researched, Yet Little Understood: Young Adults and Physical Activity

    Science.gov (United States)

    Cothran, Donetta; Kulinna, Pamela Hodges

    2005-01-01

    The authors present two beginning studies. One investigated the teaching-style preferences of young adults, and the other looked at physical activity trends within this age group. One key to understanding young adults and physical activity is to recognize the importance of participant cognition on physical activity patterns. From this…

  7. Happiness in Economics as Understood Across Ism and Religion

    OpenAIRE

    Abdul Ghafar Ismail; Nurfaradilla Haron

    2014-01-01

    The concept of happiness has been discussed long time ago by economists. Recently, it became the most related and important thing to be studied because of its impact in societies. Discussion about happiness basically interprets within two separate views. First, happiness related with economic variable, for instance, how money can create happiness. Second happiness is discussed within the context of religion. However, t...

  8. Happiness in Economics as Understood Across Ism and Religion

    Directory of Open Access Journals (Sweden)

    Abdul Ghafar Ismail

    2014-12-01

    Full Text Available The concept of happiness has been discussed long time ago by economists. Recently, it became the most related and important thing to be studied because of its impact in societies. Discussion about happiness basically interprets within two separate views. First, happiness related with economic variable, for instance, how money can create happiness. Second happiness is discussed within the context of religion. However, the discussion did not combine both contexts, economic variable and religion, to interpret happiness. Therefore, it is important to highlight the concept of happiness in a different way such as in this article. Different cultures will have their own perspective on the determination of happiness. From just “individual perspective” of happiness, they then formed an ism through involvement of a big society from the same culture. Some isms such as hedonism and materialism are synonyms in characterizing the concept of happiness in this modern world. At the same time, the isms are actually working with the economic and non-economic indicators as elements to strengthen the ism itself. On the other hand, the concept of happiness from the perspective of religion will also be a part of discussion in this article. Therefore, this article will reveal that the meaning of happiness is different in terms of religion and ism. So, to carry out both ism and religion simultaneously in shaping a more intrinsic value of happiness is not an easy task. Furthermore, religion is always associated with spiritual value that makes it hard for some people to practice religion and their isms at the same time. Thus, this article will propose that the right interpretation of isms based on their faith in religion can contribute to the concept of genuine happiness.

  9. Prevalence of obesity: A public health problem poorly understood

    Science.gov (United States)

    This review article discusses the Dietary Guidelines for Americans in support of a total diet approach to achieving diet and health goals, especially as they relate to the obesity epidemic. However, some scientists and organizations have identified one food, food group, or nutrient as the cause of t...

  10. The bare parameters of Gribov's Langrangian are understood and determined

    International Nuclear Information System (INIS)

    Bishari, M.

    1977-01-01

    In the context of the ''1/N Dual Unitarization'' scheme, an explicit dynamical study of the triple bare pomeron mechanism which governs the interaction term in Gribov's Lagrangian is presented. Together with the previously established bare pomeron slope and intercept, controlling respectively, the kinetic and mass terms in Gribov's Lagrangian, this work demonstrates the viability of the ''1/N Dual Unitarization'' approach for a field theory of interaction bare pomerons. (author)

  11. Learning Outcomes of 'Understanding Research' as understood by ...

    African Journals Online (AJOL)

    Simon Bhekumuzi

    2015-11-23

    Nov 23, 2015 ... Can Turnitin come to the rescue: From teachers' reflections? Simon Bheki Khoza ... In South Africa, however, there are very few schools that expose teachers to Turnitin in order to ... Turnitin program by John M. Barrie, when he was a graduate ... Questions. This article intended to explore and explain teach-.

  12. How Inclusive Education Is Understood by Principals of Independent Schools

    Science.gov (United States)

    Gous, Jennifer Glenda; Eloff, Irma; Moen, Melanie Carmen

    2014-01-01

    Inclusive education has become a practice that has been adopted by many schools across the globe and most usually in first-world countries. As a whole-school system, it occurs less frequently in developing countries including South Africa which unlike many developing countries has a sound infrastructure and many excellent schools in both the state…

  13. On being understood: clarity and jargon in radiation protection.

    Science.gov (United States)

    Strom, Daniel J; Watson, Charles R

    2002-03-01

    While much of the language used to express the concepts of radiation protection works effectively, there are many ill-chosen names and phrases and much jargon that permeate our professional speech and writing. From the oxymoron "internal exposure" to the "snarl word" "decay," there is much room for improvement. This essay identifies many of the problems and suggests solutions. We examine the kinds of confusions that can result from using familiar words with unfamiliar meanings and the need for neology. We offer insights into specific and unambiguous naming of physical quantities and explore the seemingly unlimited kinds of "dose." We disaggregate exposure from irradiation following intakes, and unmask units like "gram rad per microcurie hour." We call for a definition of radiation weighting factor that doesn't result in a violation of the law of conservation of energy. We examine the subtleties of distinguishing between radiation and radioactive materials. Some words, such as "exposure," have multiple meanings, while at other times there are different words or phrases with the same meaning, such as "critical level" and "decision level" or "detection level" and "minimum detectable amount." Sometimes phrases are used whose meaning is unclear or not agreed upon, such as "lower limit of detection." Sometimes there are words that are simply not apt, such as "disintegration" applied to the emission of a subatomic particle from a nucleus.

  14. Information Systems Coordinate Emergency Management

    Science.gov (United States)

    2012-01-01

    -changing planet. This information can be captured, analyzed, and visualized by geographic information systems (GIS) to produce maps, charts, and other tools that can reveal information essential to a wide variety of applications including emergency management. Knowing precise, real-time information about the size, location, environmental conditions, and resulting damage of an event like a flood or wildfire as well as the location and numbers of emergency responders and other resources contributes directly to the effectiveness of disaster mitigation. The need for such information is also evident when responding to homeland security threats, such as a terrorist attack. Recognizing the value of its geospatial information resources for this and other purposes, in 1998 Stennis and the state of Mississippi partnered to form what became the Enterprise for Innovative Geospatial Solutions (EIGS) industry cluster, supporting the growth of remote sensing and GIS-based research and business. As part of EIGS, several companies partnered with NASA through dual use and Small Business Innovation Research (SBIR) contracts. Among those was NVision.

  15. Abdominal emergencies during pregnancy.

    Science.gov (United States)

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

    2015-12-01

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

  16. Emergency planning zone reduction

    International Nuclear Information System (INIS)

    Edwards, C.

    2002-01-01

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

  17. Mechanisms of action of hormonal emergency contraceptives.

    Science.gov (United States)

    Leung, Vivian W Y; Levine, Marc; Soon, Judith A

    2010-02-01

    Hormonal emergency contraceptives have been used to prevent unwanted pregnancy for more than 3 decades. The mechanisms of action of the regimen containing a combination of estrogen and progestin, known as the Yuzpe regimen, and those of the levonorgestrel regimen continue to be controversial, especially over the possibility that these regimens might act by interfering with implantation of the fertilized ovum. We performed a search of the PubMed (1949-July 2009) and EMBASE (1980-July 2009) databases to identify literature on the mechanisms of action of these contraceptive regimens, and data were extracted from pertinent English-language studies. We classified studies according to the approach taken by the investigators to study the actions of emergency contraceptives on pregnancy: an indirect method that uses statistical models to determine whether emergency contraceptives would be as effective as reported if they act only by disrupting ovulation; direct observation of the effects of emergency contraceptives on surrogate outcomes, including ovulation, sperm activity, hormonal levels, and endometrial receptivity to implantation; and analysis of directly observed pregnancy outcomes against statistical data. Acceptability of emergency contraceptives by women and clinicians may depend on personal opinions about when life or pregnancy begins. The evidence strongly supports disruption of ovulation as a mechanism of action. The data suggest that emergency contraceptives are unlikely to act by interfering with implantation, although the possibility has not been completely excluded. The data also suggest that emergency contraceptives are ineffective after ovulation. Women and clinicians who consider implantation or later events to be the beginning of pregnancy should be aware that emergency contraceptives are likely nonabortive by this definition of pregnancy.

  18. Radiological emergencies - planning and preparedness

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-12-31

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

  19. The Emergency Department: Challenges and Opportunities for Suicide Prevention.

    Science.gov (United States)

    Asarnow, Joan Rosenbaum; Babeva, Kalina; Horstmann, Elizabeth

    2017-10-01

    Emergency departments (EDs) can offer life-saving suicide prevention care. This article focuses on the ED and emergency services as service delivery sites for suicide prevention. Characteristics of EDs, models of emergency care, ED screening and brief intervention models, and practice guidelines and parameters are reviewed. A care process model for youths at risk for suicide and self-harm is presented, with guidance for clinicians based on the scientific evidence. Strengthening emergency infrastructure and integrating effective suicide prevention strategies derived from scientific research are critical for advancing suicide prevention objectives. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Evaluating emergency risk communications: a dialogue with the experts.

    Science.gov (United States)

    Thomas, Craig W; Vanderford, Marsha L; Crouse Quinn, Sandra

    2008-10-01

    Evaluating emergency risk communications is fraught with challenges since communication can be approached from both a systemic and programmatic level. Therefore, one must consider stakeholders' perspectives, effectiveness issues, standards of evidence and utility, and channels of influence (e.g., mass media and law enforcement). Evaluation issues related to timing, evaluation questions, methods, measures, and accountability are raised in this dialogue with emergency risk communication specialists. Besides the usual evaluation competencies, evaluators in this area need to understand and work collaboratively with stakeholders and be attuned to the dynamic contextual nature of emergency risk communications. Sample resources and measures are provided here to aid in this emerging and exciting field of evaluation.

  1. Emergency Cervical Cerclage: A Case Series

    Directory of Open Access Journals (Sweden)

    Arzu Doruk

    2011-06-01

    Full Text Available OBJECTIVE: To observe the effect of the emergency cervical cerclage on the duration of pregnancy in the patient with cervical insufficiency METHOD: Thirteen pregnant women between 22-28 th gestational age treated with emergency cerclage were included in the study. Mc Donald technic was perfomed to in all patients. RESULTS: Among the patients,7 women were delivered between 25-32th weeks, and 4 patients were followed beyond the 34th week. CONCLUSION: Ultrasonographic screening to determine cervical insufficiency among the patient in the risk group should be done at 14-20th weeks for the first time. Emergency cerclage can be considered in patient without contractions or chorioamnionitis, if there is any evidence of cervical dilatation at pelvic examination.

  2. Role of Urbanization, Land-Use Diversity, and Livestock Intensification in Zoonotic Emerging Infectious Diseases

    OpenAIRE

    Saksena, Sumeet; Fox, Jefferson; Epprecht, Michael; Tran, Chinh; Castrence, Miguel; Nong, Duong; Spencer, James; Lam, Nguyen; Finucane, Melissa; Duc Vien, Tran; Wilcox, Bruce

    2014-01-01

    Emerging infectious diseases (EIDs) continue to significantly threaten human and animal health. While there has been some progress in identifying underlying proximal driving forces and causal mechanisms of disease emergence, the role of distal factors is most poorly understood. This article focuses on analyzing the statistical association between highly pathogenic avian influenza (HPAI) H5N1 and urbanization, land-use diversity and poultry intensification. A special form of the urban transiti...

  3. Crisis and the Emergence of Illicit Markets: A Pragmatist View on Economic Action outside the Law

    OpenAIRE

    Dewey, M.

    2014-01-01

    Although illicit exchange has also been an organized, silent, and ever-present response to harsh economic crisis, only protest and social movements have captured scholars’ attention. In order to fill this void, this paper analyzes the emergence of illegal markets under situations of social breakdown. I claim that an illicit market emerging under socio-economic crisis conditions might be understood as the result of a constant valuation process and the intervention of what Herbert Mead called “...

  4. Emergency treatment of complicated colorectal cancer

    OpenAIRE

    Tebala,Giovanni Domenico; Natili,Andrea; Gallucci,Antonio; Brachini,Gioia; Khan,Abdul Qayyum; Tebala,Domenico; Mingoli,Andrea

    2018-01-01

    Giovanni Domenico Tebala,1 Andrea Natili,1,2 Antonio Gallucci,1 Gioia Brachini,2 Abdul Qayyum Khan,1 Domenico Tebala,3 Andrea Mingoli2 1Colorectal Team, Noble’s Hospital, Strang, Douglas, Isle of Man, UK; 2Emergency Surgery Unit, “P.Valdoni” Department of Surgery, “Umberto I” University Hospital, Rome, Italy; 3National Institute of Statistics (ISTAT), Catanzaro, Italy Aim: To find evidence to suggest the best approach in patients admitted as ...

  5. The Emerging World Order

    Directory of Open Access Journals (Sweden)

    PETER COLLECOTT

    2014-05-01

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

  6. Emergency reactor shutdown device

    International Nuclear Information System (INIS)

    Ikehara, Morihiko.

    1982-01-01

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

  7. The emerging nuclear suppliers

    International Nuclear Information System (INIS)

    Dunn, L.A.

    1990-01-01

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

  8. Hanford Emergency Response Plan

    International Nuclear Information System (INIS)

    Wagoner, J.D.

    1994-04-01

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

  9. Emergent geometry of membranes

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-11-13

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

  10. 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.

  11. PFP Emergency Lighting Study

    International Nuclear Information System (INIS)

    BUSCH, M.S.

    2000-01-01

    NFPA 101, section 5-9 mandates that, where required by building classification, all designated emergency egress routes be provided with adequate emergency lighting in the event of a normal lighting outage. Emergency lighting is to be arranged so that egress routes are illuminated to an average of 1.0 footcandle with a minimum at any point of 0.1 footcandle, as measured at floor level. These levels are permitted to drop to 60% of their original value over the required 90 minute emergency lighting duration after a power outage. The Plutonium Finishing Plant (PFP) has two designations for battery powered egress lights ''Emergency Lights'' are those battery powered lights required by NFPA 101 to provide lighting along officially designated egress routes in those buildings meeting the correct occupancy requirements. Emergency Lights are maintained on a monthly basis by procedure ZSR-12N-001. ''Backup Lights'' are battery powered lights not required by NFPA, but installed in areas where additional light may be needed. The Backup Light locations were identified by PFP Safety and Engineering based on several factors. (1) General occupancy and type of work in the area. Areas occupied briefly during a shiftly surveillance do not require backup lighting while a room occupied fairly frequently or for significant lengths of time will need one or two Backup lights to provide general illumination of the egress points. (2) Complexity of the egress routes. Office spaces with a standard hallway/room configuration will not require Backup Lights while a large room with several subdivisions or irregularly placed rooms, doors, and equipment will require Backup Lights to make egress safer. (3) Reasonable balance between the safety benefits of additional lighting and the man-hours/exposure required for periodic light maintenance. In some plant areas such as building 236-Z, the additional maintenance time and risk of contamination do not warrant having Backup Lights installed in all rooms

  12. Emergent technologies: 25 years

    Science.gov (United States)

    Rising, Hawley K.

    2013-03-01

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

  13. Efficiency of emergency exercises

    International Nuclear Information System (INIS)

    Zander, N.; Sogalla, M.

    2011-01-01

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

  14. Characterization of radiological emergencies

    International Nuclear Information System (INIS)

    Chester, C.V.

    1985-01-01

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

  15. Ultrasonography in abdominal emergencies

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  16. 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.

  17. Common pitfalls in statistical analysis: “No evidence of effect” versus “evidence of no effect”

    Science.gov (United States)

    Ranganathan, Priya; Pramesh, C. S.; Buyse, Marc

    2015-01-01

    This article is the first in a series exploring common pitfalls in statistical analysis in biomedical research. The power of a clinical trial is the ability to find a difference between treatments, where such a difference exists. At the end of the study, the lack of difference between treatments does not mean that the treatments can be considered equivalent. The distinction between “no evidence of effect” and “evidence of no effect” needs to be understood. PMID:25657905

  18. Emergency operation determination system

    International Nuclear Information System (INIS)

    Miki, Tetsushi.

    1993-01-01

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

  19. Emerging Communities of Practice

    Science.gov (United States)

    McAlister, Martha

    2016-01-01

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

  20. 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...

  1. 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…

  2. Fire Department Emergency Response

    International Nuclear Information System (INIS)

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

    1997-09-01

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

  3. Costs of Emergency Care

    Science.gov (United States)

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

  4. 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)

  5. Financing emerging energies

    International Nuclear Information System (INIS)

    Row, J.

    2006-01-01

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

  6. 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...

  7. Emerging Art Markets

    NARCIS (Netherlands)

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

    2010-01-01

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

  8. Emergency preparedness in obstetrics.

    Science.gov (United States)

    Haeri, Sina; Marcozzi, David

    2015-04-01

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

  9. Disclosing doubtful indications for emergency cesarean sections in rural hospitals in Tanzania

    DEFF Research Database (Denmark)

    Maaløe, Nanna; Bygbjerg, Ib Christian; Onesmo, Rwakyendela

    2012-01-01

    To investigate in depth to what extent indications for emergency cesarean sections followed evidence-based audit criteria for realistic best practice.......To investigate in depth to what extent indications for emergency cesarean sections followed evidence-based audit criteria for realistic best practice....

  10. 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…

  11. Methylphenidate Actively Induces Emergence from General Anesthesia

    Science.gov (United States)

    Solt, Ken; Cotten, Joseph F.; Cimenser, Aylin; Wong, Kin F.K.; Chemali, Jessica J.; Brown, Emery N.

    2011-01-01

    Background Although accumulating evidence suggests that arousal pathways in the brain play important roles in emergence from general anesthesia, the roles of monoaminergic arousal circuits are unclear. In this study we tested the hypothesis that methylphenidate (an inhibitor of dopamine and norepinephrine transporters) induces emergence from isoflurane anesthesia. Methods Using adult rats we tested the effect of methylphenidate IV on time to emergence from isoflurane anesthesia. We then performed experiments to test separately for methylphenidate-induced changes in arousal and changes in minute ventilation. A dose-response study was performed to test for methylphenidate–induced restoration of righting during continuous isoflurane anesthesia. Surface electroencephalogram recordings were performed to observe neurophysiological changes. Plethysmography recordings and arterial blood gas analysis were performed to assess methylphenidate-induced changes in respiratory function. Droperidol IV was administered to test for inhibition of methylphenidate's actions. Results Methylphenidate decreased median time to emergence from 280 to 91 s. The median difference in time to emergence without compared to with methylphenidate was 200 [155, 331] s (median, [95% confidence interval]). During continuous inhalation of isoflurane, methylphenidate induced return of righting in a dose-dependent manner, induced a shift in electroencephalogram power from delta to theta, and induced an increase in minute ventilation. Administration of droperidol (0.5 mg/kg IV) prior to methylphenidate (5 mg/kg IV) largely inhibited methylphenidate-induced emergence behavior, electroencephalogram changes, and changes in minute ventilation. Conclusions Methylphenidate actively induces emergence from isoflurane anesthesia by increasing arousal and respiratory drive, possibly through activation of dopaminergic and adrenergic arousal circuits. Our findings suggest that methylphenidate may be clinically

  12. Emergency general surgery in the geriatric patient.

    Science.gov (United States)

    Desserud, K F; Veen, T; Søreide, K

    2016-01-01

    Emergency general surgery in the elderly is a particular challenge to the surgeon in charge of their care. The aim was to review contemporary aspects of managing elderly patients needing emergency general surgery and possible alterations to their pathways of care. This was a narrative review based on a PubMed/MEDLINE literature search up until 15 September 2015 for publications relevant to emergency general surgery in the geriatric patient. The number of patients presenting as an emergency with a general surgical condition increases with age. Up to one-quarter of all emergency admissions to hospital may be for general surgical conditions. Elderly patients are a particular challenge owing to added co-morbidity, use of drugs and risk of poor outcome. Frailty is an important potential risk factor, but difficult to monitor or manage in the emergency setting. Risk scores are not available universally. Outcomes are usually severalfold worse than after elective surgery, in terms of both higher morbidity and increased mortality. A care bundle including early diagnosis, resuscitation and organ system monitoring may benefit the elderly in particular. Communication with the patient and relatives throughout the care pathway is essential, as indications for surgery, level of care and likely outcomes may evolve. Ethical issues should also be addressed at every step on the pathway of care. Emergency general surgery in the geriatric patient needs a tailored approach to improve outcomes and avoid futile care. Although some high-quality studies exist in related fields, the overall evidence base informing perioperative acute care for the elderly remains limited. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  13. The difficult medical emergency call

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  14. Developing utility emergency preparedness exercises

    International Nuclear Information System (INIS)

    Sjoeblom, K.

    1986-01-01

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

  15. Targeting friend and foe: Emerging therapeutics in the age of gut microbiome and disease.

    Science.gov (United States)

    Cho, Jin Ah; Chinnapen, Daniel J F

    2018-03-01

    Mucosal surfaces that line our gastrointestinal tract are continuously exposed to trillions of bacteria that form a symbiotic relationship and impact host health and disease. It is only beginning to be understood that the cross-talk between the host and microbiome involve dynamic changes in commensal bacterial population, secretion, and absorption of metabolites between the host and microbiome. As emerging evidence implicates dysbiosis of gut microbiota in the pathology and progression of various diseases such as inflammatory bowel disease, obesity, and allergy, conventional treatments that either overlook the microbiome in the mechanism of action, or eliminate vast populations of microbes via wide-spectrum antibiotics need to be reconsidered. It is also becoming clear the microbiome can influence the body's response to therapeutic treatments for cancers. As such, targeting the microbiome as treatment has garnered much recent attention and excitement from numerous research labs and biotechnology companies. Treatments range from fecal microbial transplantation to precision-guided molecular approaches. Here, we survey recent progress in the development of innovative therapeutics that target the microbiome to treat disease, and highlight key findings in the interplay between host microbes and therapy.

  16. Epigenetic mechanisms in non-alcoholic fatty liver disease: An emerging field.

    Science.gov (United States)

    Gallego-Durán, Rocío; Romero-Gómez, Manuel

    2015-10-28

    Non-alcoholic fatty liver disease (NAFLD) is an emerging health concern in both developed and non-developed world, encompassing from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis and liver cancer. Incidence and prevalence of this disease are increasing due to the socioeconomic transition and change to harmful diet. Currently, gold standard method in NAFLD diagnosis is liver biopsy, despite complications and lack of accuracy due to sampling error. Further, pathogenesis of NAFLD is not fully understood, but is well-known that obesity, diabetes and metabolic derangements played a major role in disease development and progression. Besides, gut microbioma and host genetic and epigenetic background could explain considerable interindividual variability. Knowledge that epigenetics, heritable events not caused by changes in DNA sequence, contribute to development of diseases has been a revolution in the last few years. Recently, evidences are accumulating revealing the important role of epigenetics in NAFLD pathogenesis and in NASH genesis. Histone modifications, changes in DNA methylation and aberrant profiles or microRNAs could boost development of NAFLD and transition into clinical relevant status. PNPLA3 genotype GG has been associated with a more progressive disease and epigenetics could modulate this effect. The impact of epigenetic on NAFLD progression could deserve further applications on therapeutic targets together with future non-invasive methods useful for the diagnosis and staging of NAFLD.

  17. Documenting the emergence of bio-ontologies: or, why researching bioinformatics requires HPSSB.

    Science.gov (United States)

    Leonelli, Sabina

    2010-01-01

    This paper reflects on the analytic challenges emerging from the study of bioinformatic tools recently created to store and disseminate biological data, such as databases, repositories, and bio-ontologies. I focus my discussion on the Gene Ontology, a term that defines three entities at once: a classification system facilitating the distribution and use of genomic data as evidence towards new insights; an expert community specialised in the curation of those data; and a scientific institution promoting the use of this tool among experimental biologists. These three dimensions of the Gene Ontology can be clearly distinguished analytically, but are tightly intertwined in practice. I suggest that this is true of all bioinformatic tools: they need to be understood simultaneously as epistemic, social, and institutional entities, since they shape the knowledge extracted from data and at the same time regulate the organisation, development, and communication of research. This viewpoint has one important implication for the methodologies used to study these tools; that is, the need to integrate historical, philosophical, and sociological approaches. I illustrate this claim through examples of misunderstandings that may result from a narrowly disciplinary study of the Gene Ontology, as I experienced them in my own research.

  18. Emerging Directions in Emotional Episodic Memory

    Science.gov (United States)

    Dolcos, Florin; Katsumi, Yuta; Weymar, Mathias; Moore, Matthew; Tsukiura, Takashi; Dolcos, Sanda

    2017-01-01

    Building upon the existing literature on emotional memory, the present review examines emerging evidence from brain imaging investigations regarding four research directions: (1) Social Emotional Memory, (2) The Role of Emotion Regulation in the Impact of Emotion on Memory, (3) The Impact of Emotion on Associative or Relational Memory, and (4) The Role of Individual Differences in Emotional Memory. Across these four domains, available evidence demonstrates that emotion- and memory-related medial temporal lobe brain regions (amygdala and hippocampus, respectively), together with prefrontal cortical regions, play a pivotal role during both encoding and retrieval of emotional episodic memories. This evidence sheds light on the neural mechanisms of emotional memories in healthy functioning, and has important implications for understanding clinical conditions that are associated with negative affective biases in encoding and retrieving emotional memories. PMID:29255432

  19. Emerging Administrations under European Union Rules

    Directory of Open Access Journals (Sweden)

    Bogdan Berceanu

    2012-05-01

    Full Text Available The idea of emergence is generally used to indicate the appearance of patterns, structures, orproperties that cannot be adequately explained by referring only to the system’s pre-existing componentsand their interactions. The term “emergence” has an interdisciplinary approach specific to administrativesciences, too. In this article, the concept of “emergence” signifies lato sensu a kind of change and it will beused to refer to countries that have a high volatility and that are in transition and to define the changes thatsuffer the public administrations of the countries which are part of the European construction. EuropeanUnion through its policies and legislation has a great impact on economic and social conditions in MemberStates. The aim of the paper is to present a theoretical approach on the dimension of emergingadministrations understood as changes and reforms that suffer the institutions from the EU member statesunder the pressure of the European Union rules. The study is using the concept of emergence to researchand to analyze the nature of the changes in the public administration starting from the approach of thesystems theory.

  20. Blog and Podcast Watch: Neurologic Emergencies

    Directory of Open Access Journals (Sweden)

    Andrew Grock

    2016-11-01

    Full Text Available Introduction: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM based on the ongoing ALiEM Approved Instructional Resources (AIR and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of neurologic emergencies from the AIR series. Methods: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Director’s (CORD annual testing schedule. For each module, relevant content is collected from the top 50 Social Media Index sites published within the previous 12 months, and scored by eight board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an honorable mention label, if the executive board agrees that the post is accurate and educationally valuable. Results: A total of 125 blog posts and podcasts were evaluated. Key educational pearls from the 14 AIR posts are summarized, and the 20 honorable mentions are listed. Conclusion: The WestJEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expert-based, post-publication curation of educational social media content for EM clinicians with this installment focusing on neurologic emergencies.