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Mass-casualty incidents (MCIs) place extraordinary demands on prehospital medical response. However, there remains limited evidence on best practices in managing MCIs, and therefore, there is a need to systematically synthetize experiences from them to build further evidence.
Study Objective:
This study aimed to analyze common challenges in prehospital MCI management.
Methods:
Seventeen case studies or reports describing 15 MCIs (ie, terrorist attacks, chemical incidents, traffic accidents, weather-related incidents, and fires) were subject to a systematic integrative review.
Results:
Common challenges in prehospital MCI management include victim and responder safety- and security-related issues; the need to develop and communicate situational awareness; to develop and apply a prehospital response plan; the ability to deliver care under severe circumstances; and the need for an extended prehospital medical response management strategy.
Conclusion:
Resilient prehospital MCI response demands both a clear strategy and improvisation and should be integrated into the overall medical response strategy. Responders must understand the main concepts of prehospital MCI management, have a situational awareness that foresees the event’s medical consequences, and have the experience required to interpret the situation. Emergency Medical Services (EMS) personnel and medical incident commanders require specific training and mental preparation to be able to provide care under severe security threats, to improvise beyond routines and guidelines, and to provide care in ways different from their everyday work.
Chapter 6 traces how, in the aftermath of these reforms, the Neogranadian church, at the parish level, became an Indigenous and grassroots organisation. One aspect of this transformation was institutional, as it came to be better staffed, organised, and equipped. Another was ideological, as the lessons of the Jesuit experiments with missionary methods were extended across the archdiocese, centring everyday practice, popular devotion, and social institutions. But the most significant aspect was led by Indigenous people themselves, as the shift away from punitive policies and towards a more inclusive Christianisation, coupled with the implementation of a more effective language policy, created space and opportunities for people in rural parishes to interact with Christianity in new ways. This went much further than the authorities had intended, as they learned when they sought to rein in some of these changes, and it transformed the New Kingdom of Granada forever.
The blow-up of the anticanonical base point on a del Pezzo surface S of degree 1 gives rise to a rational elliptic surface $\mathscr {E}$ with only irreducible fibers. The sections of minimal height of $\mathscr {E}$ are in correspondence with the $240$ exceptional curves on S. A natural question arises when studying the configuration of these curves: if a point on S is contained in “many” exceptional curves, is it torsion on its fiber on $\mathscr {E}$? In 2005, Kuwata proved for the analogous question on del Pezzo surfaces of degree $2$, where there are 56 exceptional curves, that if “many” equals $4$ or more, the answer is yes. In this paper, we prove that for del Pezzo surfaces of degree 1, the answer is yes if ‘many’ equals $9$ or more. Moreover, we give counterexamples where a non-torsion point lies in the intersection of $7$ exceptional curves. We give partial results for the still open case of 8 intersecting exceptional curves.
As its name indicates, algorithmic regulation relies on the automation of regulatory processes through algorithms. Examining the impact of algorithmic regulation on the rule of law hence first requires an understanding of how algorithms work. In this chapter, I therefore start by focusing on the technical aspects of algorithmic systems (Section 2.1), and complement this discussion with an overview of their societal impact, emphasising their societal embeddedness and the consequences thereof (Section 2.2). Next, I examine how and why public authorities rely on algorithmic systems to inform and take administrative acts, with special attention to the historical adoption of such systems, and their impact on the role of discretion (Section 2.3). Finally, I draw some conclusions for subsequent chapters (Section 2.4).
This article addresses power-sharing constitutions that include powers of veto wielded by discrete ethnonational groups. Such constitutional arrangements – seen, for example, in Northern Ireland and Bosnia – have often prompted severe deadlock, a problem that in turn threatens democratic functioning and raises the risk of renewed communal violence. We consider the use of ‘umpires’ of power-sharing constitutional systems to vet the use of vetoes and (potentially) to prevent their overuse or misuse. Power-sharing umpires are not uncommon in practice. However, as yet there is little scholarship evaluating how, in substance, power-sharing veto umpires should approach their task. Relying on deliberative democracy theory, the article outlines three forms of ‘deliberative agreement’ that, in principle, deeply divided groups may reach in the course of policymaking. It goes on to explain how existing proportionality doctrines drawn from federalism and rights cases can be imported into the power-sharing context to ‘scaffold’ these broad ideals. This approach, it is argued, may provide a more detailed, coherent and practically workable approach to umpiring power-sharing constitutions.
Edited by
Daniel Benoliel, University of Haifa, Israel,Peter K. Yu, Texas A & M University School of Law,Francis Gurry, World Intellectual Property Organization,Keun Lee, Seoul National University
The main purpose of this chapter is to study gender inequality within the inventive activities in three emerging countries – Brazil, India, and Mexico – using the framework of knowledge economics. It aims to determine which factors that influence a growing propensity of women to be inventors help reduce gender inequality in knowledge economies. In addition, the chapter contributes policy proposals that aim at increasing female participation in inventive activities. The key questions for this research are as follows: What are the characteristics and dynamics of female inventive activities in emerging countries with different economic development paths? What factors influence women’s propensity to invent? Based on the results of the econometric model proposed in this chapter, the inventive variables, such as the stock of prior knowledge, the size of inventor teams, the type of patent holder, technological field, and the presence of foreign researchers – positively influence women’s propensity to become inventors in a differentiated manner in each country. These findings validate how some variables could influence the inclusion of a greater number of women in research teams and the deployment of their potential inventive activities. The chapter proposes policies aimed at reducing gender inequality in the knowledge economy.
The so-called “Prakhon Chai Hoard” is one of Southeast Asia’s most infamous cases of looting. The story begins in 1964 when a cache of Buddhist bronzes from Northeast Thailand appeared on the international art market via the auction house Spink & Son, London. They quickly ended up in museums and private collections throughout the US and Europe. The exact findspot was unclear but soon became associated with an unidentified temple in Prakhon Chai district in Buriram province. The moniker “Prakhon Chai Hoard/bronzes” subsequently took hold, becoming commonplace in museum displays, dealer/auction house catalogs, and art historical discourse. However, in 2002, it was revealed the temple in question was Plai Bat II in Lahan Sai district.
This article untangles the many myths and misunderstandings surrounding this act of looting. It does so by reviewing the extant literature in light of information revealed by criminal investigations into the late Douglas Latchford from 2012 onwards, and presenting conclusions drawn from our decade-long documentation of villager testimonies at Plai Bat II (2014–2024).
This study aimed to explore the multifaceted experiences of families with children and adolescents enrolled in the pediatric palliative care (PPC) program, with a particular emphasis on understanding their perspectives regarding the quality and effectiveness of care provided. Our goals included exploring emotional, social, and practical caregiving dimensions within the PPC context to address gaps and find areas for improvement. The objectives encompassed an exploration of the perceived effects on physical, emotional, social, and spiritual dimensions, an investigation into pre-PPC inclusion experiences, and an identification of limitations and potential areas for enhancement within the program.
Methods
Using a qualitative descriptive approach with a phenomenological lens, we engaged 6 primary caregivers through semi-structured interviews, employing theoretical convenience sampling. Analysis involved meticulous transcription, alphanumeric coding, and thematic categorization using Atlas.ti 8.0® software.
Results
Consistently echoed across interviews were the positive impacts on family dynamics, characterized by a sense of tranquility, enhanced patient care, and substantial caregiver support. Emotional well-being improvements were marked by elevated mood, reduced anxiety, and a restored sense of normalcy. Noteworthy challenges identified encompassed communication gaps among health-care professionals, limited-service availability, and perceived constraints in home care.
Significance of results
The study underscores the profound positive influence of the PPC program on the perceived quality of life for families navigating the complexities of caring for children with life-limiting illnesses. The findings underscore the paramount importance of holistic, family-centric care and underscore the imperative to address caregiver needs comprehensively to mitigate the risk of burnout. The identified challenges serve as signposts for refining communication strategies, expanding service provisions, and augmenting support structures within the PPC program. Overall, the study highlights the profound positive impact of the PPC program on family well-being, while also identifying areas for program enhancement, particularly in communication and service availability.
This study investigated the effect of phonological neighborhood density (PND) on the lexical encoding of perceptually confusable segmental contrasts and the extent to which the precision of encoding is modulated by phonetic categorization and vocabulary size. Korean learners of English and native speakers of American English completed an auditory lexical decision task that contained words and nonwords with /ɛ/, /æ/, /f/, and /p/ (/æ/ and /f/ do not exist in Korean), two phonetic categorization tasks (/ɛ/−/æ/ and /f/−/p/), and a vocabulary test. For the Korean group, participants’ categorization of /f/−/p/ was the only significant predictor of /f/−/p/ nonword rejection. For /ɛ/−/æ/, nonword versions of high PND words were rejected more accurately than low PND. Additionally, vocabulary size and phonetic categorization significantly interacted so that as perception abilities improve, the benefits that come from having a large vocabulary grow as well.
In this book, I examined how public authorities’ reliance on algorithmic regulation can affect the rule of law and erode its protective role. I conceptualised this threat as algorithmic rule by law and evaluated the EU legal framework’s safeguards to counter it. In this chapter, I summarise my findings, conclude that this threat is insufficiently addressed (Section 6.1) and provide a number of recommendations (Section 6.2). Finally, I offer some closing remarks (Section 6.3). Algorithmic regulation promises simplicity and a route to avoid the complex tensions of legal rules that are continuously open to multiple interpretations. Yet the same promise also threatens liberal democracy today, as illiberal and authoritarian tendencies seek to eliminate plurality in favour of simplicity. The threat of algorithmic rule by law is hence the same that also threatens liberal democracy: the elimination of normative tensions by essentialising a single view. The antidote is hence to accept not only the normative tensions that are inherent in law but also the tensions inherent in a pluralistic society. We should not essentialise the law’s interpretation, but embrace its normative complexity.
Since Cannon, inspired by Bernard’s discussion of the conditions required for free and independent life, introduced the term homeostasis, many have embraced it as the main theoretical principle guiding physiology and medicine. Nonetheless, critics have argued that homeostasis is too limiting and have advanced a variety of alternative concepts such as heterostasis, rheostasis, and allostasis. We argue that the critics target a much narrower understanding of homeostasis put forward by the cyberneticists and that Bernard and Cannon embraced a far broader understanding that can accommodate the alternatives advanced by the critics and provide an integrated theoretical framework for physiology.
Statistical learning, that is, our ability to track and learn from distributional information in the environment, plays a fundamental role in language acquisition, yet little research has investigated this process in older language learners. In the present study, we address this gap by comparing the cross-situational learning of foreign words in younger and older adults. We also tested whether learning was affected by previous experience with multiple languages. We found that both age groups successfully learned the novel words after a short exposure period, confirming that statistical learning ability is preserved in late adulthood. However, the two groups differed in their learning trajectories, with the younger group outperforming the older group during the later stages of learning. Previous language experience did not predict learning outcomes. Given that implicit language learning mechanisms are shown to be preserved over the lifespan, the present data provide crucial support for the assumptions underlying claims that language learning interventions in older age could be leveraged as a targeted intervention to help build or maintain resilience to age-related cognitive decline.
The conclusion reflects on the profound transformations undergone by the New Kingdom of Granada by the late seventeenth century, and how this began to powerfully shape the images of the early colonial past that began to appear in works of historical writing in that period, with long-lasting consequences. This triumphal register of writing, that cast the Muisca as the third great empire of the Americas and asserted the swift success of the Spanish colonial administration, has long obscured perceptions about the Indigenous people of highland New Granada. As this book has demonstrated, a granular exploration of an exhaustive array of colonial archival sources paints a very different picture: on the one hand, of the anxieties and limitations at the heart of the colonial project, the incomplete and contingent nature of colonial power, and of deep and multi-layered crises of governance; and on the other, of the complex ways in which Indigenous people, in their interaction with Christianity, made possible the coming of the New Kingdom of Granada.
This chapter explores the action for damages as a remedy for fundamental rights violations committed by the EU. Especially considering the shortcomings of the other direct avenues to the CJEU, this mechanism is essential to ensure full compliance with the right to an effective remedy within the EU legal order. Its potential lies in its accessibility to individuals as well as its substantive flexibility that leaves significant room for the CJEU to craft a liability regime suitable to the EU. Yet the action for damages is currently not very effective as a fundamental rights remedy. This is largely due to two factors: the Court’s insistence on the sufficiently serious breach test and the limits to the establishment and enforcement of joint liability. To ensure full compliance with the right to an effective remedy, the CJEU may rely on Article 47 of the Charter and the approaches adopted in national liability laws to develop a fundamental rights specific regime for damages liability. Alternatively, a fundamental rights specific liability regime may also be achieved through secondary legislation.
This article explores the oral narratives about Samuel Ezekiel Divekar (1730–97), an officer in the British army and a member of the Bene Israel Indian Jewish community, who was released from the prison of Tipu Sultan (1751–99) by the Muslim ruler’s mother, Begum Fatima Fakhr-un-Nisa. These foundational narratives are compared with non-native colonial and other sources, including manuscripts, books, letters and reports located in libraries and archives, in order to see whether there is any synchronicity between the different versions. Of particular interest is the gender dimension in which Divekar’s release from prison was facilitated by a Muslim woman, reminiscent of the biblical story of Joseph and Potiphar’s wife in Egypt. Although prominent in the Bene Israel communal narrative, the Begum’s role is reflected neither in colonial records nor in other accounts (notably, in Cochin Jewish letters). Finally, the question of whether Divekar brought a Torah scroll to the Gate of Mercy synagogue (so named to commemorate the compassion of the Begum) established in 1796 in Bombay is discussed. The article demonstrates that the analysis of subaltern oral narratives can enrich our understanding of history by giving a voice to marginalised groups, and focusing on suppressed narratives about gender.
Edited by
Daniel Benoliel, University of Haifa, Israel,Peter K. Yu, Texas A & M University School of Law,Francis Gurry, World Intellectual Property Organization,Keun Lee, Seoul National University