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Disaster planning and preparedness for a burn mass casualty incident (BMCI) must consider the needs of those who will be directly involved and support the response to such an event. An aspect of developing a more comprehensive statewide burn disaster program included meeting (regionally) with healthcare coalitions (HCC) to identify gaps in care and deficiencies.
Method:
Regularly scheduled (quarterly) HCC meetings are held around the state linking stakeholders representing local hospitals, health departments, emergency medical services (EMS) agencies, and other interested parties. We were able to use the HCCs regional meetings to serve as a platform for conducting focus group research to identify gaps specific to a BMCI and to inform strategy development for a statewide approach. Additionally, we held engagement meetings with state emergency response network (a state agency that coordinates the movement of ambulances to appropriate destinations) and the Burn Medical Directors findings were vetted from the focus groups.
Results:
One of the deficiencies identified, included a lack of burn-specific wound care dressings that could support the initial response. Relying on this same process, a consensus was attained for equipment types and quantities, including a kit for storage. Furthermore, a maintenance, supply replacement, and delivery to the scene processes were developed for these kits of supplies that could augment a BMCI response.
Conclusion:
Focus group feedback reminded us that outside of the world of burn care, many report an infrequent opportunity to provide care for patients with burn injuries. Several types of burn-specific dressings can be expensive, and with the occurrence being infrequent. EMS agencies and rural hospitals alike reported that it was unlikely their agency/hospital would have more than a minimal stock of burn injury supplies. Developing supply caches that can be quickly mobilized and deployed to the impacted area was one of the deficiencies we addressed.
This discussion paper by a group of scholars across the fields of health, economics and labour relations argues that COVID-19 is an unprecedented humanitarian crisis from which there can be no return to the ‘old normal’. The pandemic’s disastrous worldwide health impacts have been exacerbated by, and have compounded, the unsustainability of economic globalisation based on the neoliberal dismantling of state capabilities in favour of markets. Flow-on economic impacts have simultaneously created major supply and demand disruptions, and highlighted the growing within-country inequalities and precarity generated by neoliberal regimes of labour market regulation. Taking an Australian and international perspective, we examine these economic and labour market impacts, paying particular attention to differential impacts on First Nations people, developing countries, women, immigrants and young people. Evaluating policy responses in a political climate of national and international leadership very different from those in which major twentieth century crises were addressed, we argue the need for a national and international conversation to develop a new pathway out of crisis.
We use a mathematical model to investigate the effect of basal topography and ice surface slope on transport and deposition of sediment within a water-filled subglacial channel. In our model, three zones of different behaviour occur. In the zone furthest upstream, variations in basal topography lead to sediment deposition under a wide range of conditions. In this first zone, even very small and gradually varying basal undulations (~5 m amplitude) can lead to the deposition of sediment within a modelled channel. Deposition is concentrated on the downstream gradient of subglacial ridges, and on the upstream gradient of subglacial troughs. The thickness and steepness of the ice sheet has a substantial impact on deposition rates, with shallow ice profiles strongly promoting both the magnitude and extent of sediment deposition. In a second zone, all sediment is transported downstream. Finally, a third zone close to the ice margin is characterised by high rates of sediment deposition. The existence of these zones has implications for esker formation and the dynamics of the subglacial environment.
This chapter discusses expatriate recruitment sources, methods, and the expatriates’ motivations to work abroad. Then it examines expatriate selection criteria, methods, and how expatriates are selected in practice. The chapter also presents the variety of expatriate preparation methods, discusses expatriate training effectiveness, and expatriate preparation in practice. It concludes by considering future avenues of research. Overall, in the area of selection and preparation for international assignments there is good material for researchers to build on and a growing understanding of the key issues. Nevertheless, there remains here a rich field for exciting research in the future.
Mental, neurological and substance use (MNS) disorders are a leading, but neglected, cause of morbidity and mortality in sub-Saharan Africa. The treatment gap for MNS is vast with only 10% of people with MNS disorders in low-income countries accessing evidence-based treatments. Reasons for this include low awareness of the burden of MNS disorders and limited evidence to support development, adaptation and implementation of effective and feasible treatments. The overall goal of the African Mental Health Research Initiative (AMARI) is to build an African-led network of MNS researchers in Ethiopia, Malawi, South Africa and Zimbabwe, who are equipped to lead high quality mental health research programs that meet the needs of their countries, and to establish a sustainable career pipeline for these researchers with an emphasis on integrating MNS research into existing programs such as HIV/AIDS. This paper describes the process leading to the development of AMARI's objectives through a theory of change workshop, successes and challenges that have been faced by the consortium in the last 4 years, and the future role that AMARI could play in further building MNS research capacity by brining on board more institutions from low- and middle-income countries with an emphasis on developing an evidence-based training curriculum and a research-driven care service.
Schmidt-hammer exposure-age dating (SHD) was applied at 15 sites with glacially-transported granite boulders in parts of northern and western Ireland and southwest Scotland that had been exposed by retreat of the last British-Irish Ice Sheet (BIIS) or Younger Dryas (YD) ice masses. Seven of these surfaces had previously been dated using terrestrial cosmogenic nuclide (TCN) exposure-age dating. Application of the granite calibration equation of Tomkins et al. (2018c) indicated a close correspondence between the SHD ages and the TCN ages (within 1σ or 2σ uncertainties). These findings demonstrate that SHD ages can be of comparable accuracy, precision, and reliability to TCN ages and are a strong argument for the more extensive use of SHD in some Quaternary dating projects. However, surface ages obtained by both SHD and TCN dating should not be accepted uncritically; they must be assessed in relation to the wider geological, geomorphological, and geochronological evidence. Evaluation of eight SHD ages, for which corresponding TCN ages are not available, indicate that most are consistent with current theory and field evidence, but some anomalous age estimates occur.
This article presents a novel analysis of Negative Auxiliary Inversion (NAI) constructions such as didn't many people eat, in which a negated auxiliary appears in pre-subject position. NAI, found in varieties including Appalachian, African American, and West Texas English, has a word order identical to a yes/no question, but is pronounced and interpreted as a declarative. We propose that NAI subjects are negative DPs, and that the negation raises from the subject DP to adjoin to Fin (a functional head in the left periphery). Three properties of NAI motivate this analysis: (i) scope freezing effects, (ii) the various possible and impossible NAI subject types, and (iii) the incompatibility of NAI constructions with true Double-Negation interpretations. Implications for theories of Negative Concord, Negative Polarity Items, and the representation of negation are discussed.
The Icelandic crust is characterized by low δ18O values that originate from pervasive high-temperature hydrothermal alteration by 18O-depleted meteoric waters. Igneous rocks in Iceland with δ18O values significantly higher than unaltered oceanic crust (~5.7‰) are therefore rare. Here we report on rhyolitic intra-caldera samples from a cluster of Neogene central volcanoes in Borgarfjörður Eystri, Northeast Iceland, that show whole-rock δ18O values between +2.9 and +17.6‰ (n = 6), placing them among the highest δ18O values thus far recorded for Iceland. Extra-caldera rhyolite samples from the region, in turn, show δ18O whole-rock values between +3.7 and +7.8‰ (n = 6), consistent with the range of previously reported Icelandic rhyolites. Feldspar in the intra-caldera samples (n = 4) show δ18O values between +4.9 and +18.7‰, whereas pyroxene (n = 4) shows overall low δ18O values of +4.0 to +4.2‰, consistent with regional rhyolite values. In combination with the evidence from mineralogy and rock H2O contents, the high whole-rock δ18O values of the intra-caldera rhyolites appear to be the result of pervasive isotopic exchange during subsolidus hydrothermal alteration with 18O-enriched water. This alteration conceivably occurred in a near-surface hot spring environment at the distal end of an intra-caldera hydrothermal system, and was probably fed by waters that had already undergone significant isotope exchange with the country rock. Alternatively, 18O-enriched alteration fluids may have been produced during evaporation and boiling of standing water in former caldera lakes, which then interacted with the intra-caldera rock suites. Irrespective of the exact exchange processes involved, a previously unrecognized and highly localized δ18O-enriched rock composition exists on Iceland and thus probably within the Icelandic crust too.
The purpose of this paper is to substantiate the importance of research about barriers and levers to the implementation of supports for cross-cultural communication in primary care settings in Europe. After an overview of migrant health issues, with the focus on communication in cross-cultural consultations in primary care and the importance of language barriers, we highlight the fact that there are serious problems in routine practice that persist over time and across different European settings. Language and cultural barriers hamper communication in consultations between doctors and migrants, with a range of negative effects including poorer compliance and a greater propensity to access emergency services. It is well established that there is a need for skilled interpreters and for professionals who are culturally competent to address this problem. A range of professional guidelines and training initiatives exist that support the communication in cross-cultural consultations in primary care. However, these are commonly not implemented in daily practice. It is as yet unknown why professionals do not accept or implement these guidelines and interventions, or under what circumstances they would do so. A new study involving six European countries, RESTORE (REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings), aims to address these gaps in knowledge. It uses a unique combination of a contemporary social theory, normalisation process theory (NPT) and participatory learning and action (PLA) research. This should enhance understanding of the levers and barriers to implementation, as well as providing stakeholders, with the opportunity to generate creative solutions to problems experienced with the implementation of such interventions.
In the elderly, immunosenescence and malnourishment can contribute to increased risk and severity of upper respiratory tract infections (URTI). Gold kiwifruit (Actinidia chinensis ‘Hort16A’) contains nutrients important for immune function and mitigation of symptoms of infection, including vitamins C and E, folate, polyphenols and carotenoids. The objective of the present study was to evaluate whether regular consumption of gold kiwifruit reduces symptoms of URTI in older people, and determine the effect it has on plasma antioxidants, and markers of oxidative stress, inflammation and immune function. A total of thirty-two community-dwelling people ( ≥ 65 years) participated in a randomised crossover study, consuming the equivalent of four kiwifruit or two bananas daily for 4 weeks, with treatments separated by a 4-week washout period. Participants completed the Wisconsin Upper Respiratory Symptom Survey-21 daily, and blood samples were collected at baseline and at the end of each treatment and washout period. Gold kiwifruit did not significantly reduce the overall incidence of URTI compared with banana, but significantly reduced the severity and duration of head congestion, and the duration of sore throat. Gold kiwifruit significantly increased plasma vitamin C, α-tocopherol and lutein/zeaxanthin concentrations, and erythrocyte folate concentrations, and significantly reduced plasma lipid peroxidation. No changes to innate immune function (natural killer cell activity, phagocytosis) or inflammation markers (high-sensitivity C-reactive protein, homocysteine) were detected. Consumption of gold kiwifruit enhanced the concentrations of several dietary plasma analytes, which may contribute to reduced duration and severity of selected URTI symptoms, offering a novel tool for reducing the burden of URTI in older individuals.
The focus of this themed section is on identifying gaps in anti-poverty policy towards children and young people. The idea to address this question originated at the conference ‘A Fairer Society? A Review of Policies for Vulnerable Groups’ organised by the Centre for Research in Social Policy (CRSP) at Loughborough University in September 2006. The section offers a combination of papers from the conference (Bradshaw and Richardson; Smith; Sutton) and papers commissioned specifically to deal with gaps in anti-poverty policy towards children and young people (Lloyd; France; Phung). An overview of some useful sources has also been included (Davis and Sandu).
Objective: To report on the use of the New Zealand Quitline for recruiting participants to a smoking cessation trial. Methods: Analysis of data on trial recruitment and randomisation. Results: 68% of 26,369 callers to the New Zealand Quitline over 12 months indicated an interest in taking part in research, 28% of whom met eligibility criteria for a cessation intervention trial, assessed on the data routinely collected at Quitline registration. Of these, 1317 (26%) were contacted by call back with 1027 (78%) agreeing to take part in the trial. After further eligibility checking 851 people were randomised. Weighting of calls ensured that 25% of participants were Maori. Conclusions: Quitlines have good potential to be an effective means of randomising participants into cessation trials and ensuring adequate representation of underrepresented population groups.
We have shown recently that the degradation of AC electroluminescence (EL) in ZnS:Cu,Cl and similar phosphors can be significantly reversed by a short anneal near 200°C. To better understand the degradation/rejuvenation processes, we investigated EL degradation and rejuvenation under different conditions. To probe for changes in the local atomic structure about the Cu sites, we collected Extended X-ray Absorption Fine Structure (EXAFS) data at the Cu K-edge EXAFS data for several as-made, thermally degraded (240°C anneal), and EL degraded powders.
We investigate the behavior of a polymer blend (M3EH-PPV:CN-ether-PPV) bulk heterojunction solar cell using a numeric model that self-consistently solves Poisson's equation and the charge continuity equation while incorporating electric field dependent mobilities. We obtain good quantitative agreement with present experimental data for J-V curves and photocurrent action spectra. To reproduce experimental photocurrent action spectra, our model predicts 36% exciton dissociation efficiencies in the bulk of the polymer. We also study the limiting conditions of polymer solar cell development by simulating an ideal solar cell using an AM1.5 global spectrum and assuming all absorbed photons hitting a M3EH-PPV:CN-ether-PPV polymer blend (band gap ∼2.0 eV) based solar cell at normal incidence contribute to current. If such a solar cell has 100 nm length, open circuit voltage=0.6 V and 50% fill factor, then the maximum theoretical power conversion efficiency is ηp=5.6%. A similar analysis for a M3EH-PPV:PCBM bulk heterojunction cell yields, ηp=3.5%. These results further highlight the need to develop smaller band gap materials and help explain why the best polymer based solar cells have power conversion efficiencies that remain stuck at about 3%. Our model is used to investigate the important increase in power conversion efficiencies we can expect as lower band gap polymers become available.
As the number of deployed multi-agent applications increases, further and better experience with the technology is gained, enabling a strong evaluation of the field from a more practical perspective. In particular, questions relating to how the theory of multi-agent systems impacts on practice, and how the practical development itself compares with other technologies, can be answered in the light of a heightened level of maturity. Given the tensions between theoreticians and practitioners in computing in general, let alone their spats in AI or multi-agent systems in particular, the discussion on agent systems and applications was both vigorous and enthusiastic
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