A type of emergency decision-making which has not received research attention is the police search for a lost person in a rural or wilderness area. For many such incidents, decisions concerning where to search for the lost subject are made by a planning team, each member of which assigns probabilities to the various hypotheses about where the subject might be located, including the residual hypothesis that the subject is somewhere else entirely, that is, outside of the designated search area. In the current study, 32 adult males with search planning experience were asked to assign probabilities to a fictional lost person incident. It was hypothesized, according to support theory (Tversky & Koehler, 1994), that subjects who first considered the five possible scenarios accounting for how the subject could have left the search area—i.e., unpacked the residual hypothesis—would subsequently increase their probability estimate of the global hypothesis that the missing subject was not in the designated search area, compared to those subjects who unpacked the focal hypothesis. This hypothesis was confirmed. We also found considerable evidence for subadditivity, as most subjects estimated higher summed probabilities for the individual scenarios accounting for the focal and residual hypotheses, respectively. The potential negative consequences of such unpacking effects during a lost person incident were discussed, and possible means of mitigating such effects were described.

Background. Primary care providers play a key role in screening for tobacco use and assessing desire to quit. Tobacco treatment specialists (TTS) are certified in helping patients who desire tobacco cessation. A primary care nurse practitioner within one Midwestern healthcare organization obtained TTS certification and integrated specialized tobacco cessation visits within a primary care clinic from February 2021 to February 2022. Purpose. To determine the efficiency and effectiveness of an integrated TTS-certified nurse practitioner (TTS-NP) in a primary care setting 1-year postimplementation. Method. This program evaluation utilized retrospective electronic health record review and included thirty-three patients. The logic model served as a framework to define efficiency and effectiveness. Results. Patients were referred by a provider (57.6%), nurse (15.2%), or self (27.3). Patients opted for in-person initial visits (81.8%) more than virtual (18.2%). Of a total of 73 scheduled visits, 8 (11%) were no-showed. Patients who self-referred had the lowest no-show rate (5.6%) compared to those referred by a provider (12.8%) or nurse (12.5%). Of the patients included, 87.9% set a goal quit date. Average time until first and second follow-up was 34.6 and 130.4 days after goal quit date. Follow-up was defined as the date of the patient’s first message reply to the TTS-NP, or first visit following the goal quit date. A total of 51.9% (n = 14) and 63% (n = 17) reported cessation at the first and second follow-up. TTS-NP visit’s cost, independent of any other coverage, was less than other specialty visits in primary care. Conclusion. TTS-NP visits in primary care enabled patients to benefit from lower cost and longitudinal follow-up within a familiar setting. Over half of patients achieved cessation. Results of this program evaluation suggest support for TTS-certified providers in primary care.

IAU Commission 29 - Stellar Spectra has been one of the IAU commissions from the onset, until its dissolution at the most recent IAU General Assembly in Honolulu in 2015. This commission belonged to IAU Division G (“Stars and Stellar Physics”), the latter committed with fostering research in stellar astrophysics. Within the general field of stellar astrophysics, stellar spectroscopy plays a key role, as stellar spectra are a powerful tool providing a view into the detailed physical properties of stars and the physical processes occuring within them.

The purpose of this article is to set the context for this special issue of Disaster Medicine and Public Health Preparedness on the allocation of scarce resources in an improvised nuclear device incident. A nuclear detonation occurs when a sufficient amount of fissile material is brought suddenly together to reach critical mass and cause an explosion. Although the chance of a nuclear detonation is thought to be small, the consequences are potentially catastrophic, so planning for an effective medical response is necessary, albeit complex. A substantial nuclear detonation will result in physical effects and a great number of casualties that will require an organized medical response to save lives. With this type of incident, the demand for resources to treat casualties will far exceed what is available. To meet the goal of providing medical care (including symptomatic/palliative care) with fairness as the underlying ethical principle, planning for allocation of scarce resources among all involved sectors needs to be integrated and practiced. With thoughtful and realistic planning, the medical response in the chaotic environment may be made more effective and efficient for both victims and medical responders.

(Disaster Med Public Health Preparedness. 2011;5:S20-S31)

SoonAfter John F. Kennedy became President, difficult foreign policy decisions had to be made. Even before he assumed the burdens of office, he knew an early judgment would be required concerning United States policies vis-à-vis Laos. Throughout 1960, Communist forces in Laos and their allies won numerous military victories and the Laotian Royal Army was unable to check their advances. The United States and other SEATO members were understandably disturbed. They now had to contemplate a total Communist victory with all its potentially painful and embarrassing consequences. These consequences worried President-elect Kennedy and prior to his inauguration, he and his advisors began systematically examining all their policy alternatives; they found that none were really attractive.

Despite the large numbers of displaced persons and the often-lengthy periods of displacement, little is known about the impact of forced migration on long-term under-five mortality. This paper looks at the Brass Method (and adaptations of this method) and the Preceding Birth Technique in combination with a classification of women by their migration and reproductive histories, in order to study the impact of forced migration on under-five mortality. Data came from the Demography of Forced Migration Project, a study on mortality, fertility and violence in the refugee and host populations of Arua District, Uganda and Yei River District, Sudan. Results indicate that women who did not migrate in a situation of conflict and women who repatriated before the age of 15, had children with the highest under-five mortality rates compared with women who were currently refugees and women who repatriated after the age of 15.

Peter Trudgill & Jean Hannah, International English: A guide to varieties of Standard English. 4th ed. London: Arnold; New York: Oxford University Press, 2002. Pp. i–xv, 1–153. Pb $22.95.

This book provides a delightful survey of the global variety of pronunciation and usage of English as an educated standard. It focuses on the phonetics of the various Englishes, especially on the vowels, where so much of the variability resides, and on differences in usage, lexical and syntactic as well as orthographic. Although this small volume necessarily deals with most topics briefly, it includes a wealth of detail.

Child mortality (the mortality of children less than five years old) declined considerably in the developing world in the 1990s, but infant mortality declined less. The reductions in neonatal mortality were not impressive and, as a consequence, there is an increasing percentage of infant deaths in the neonatal period. Any further reduction in child mortality, therefore, requires an understanding of the determinants of neonatal mortality. 209,628 birth and 2581 neonatal death records for the 1998 birth cohort from the city of São Paulo, Brazil, were probabilistically matched. Data were from SINASC and SIM, Information Systems on Live Births and Deaths of Brazil. Logistic regression was used to find the association between neonatal mortality and the following risk factors: birth weight, gestational age, Apgar scores at 1 and 5 minutes, delivery mode, plurality, sex, maternal education, maternal age, number of prior losses, prenatal care, race, parity and community development. Infants of older mothers were less likely to die in the neonatal period. Caesarean delivery was not found to be associated with neonatal mortality. Low birth weight, pre-term birth and low Apgar scores were associated with neonatal death. Having a mother who lives in the highest developed community decreased the odds of neonatal death, suggesting that factors not measured in this study are behind such association. This result may also indicate that other factors over and above biological and more proximate factors could affect neonatal death.

Provision of services for older people is now a priority for policy makers, not least because of population aging precipitating a ‘demographic revolution’. In England, one response by policy-makers has been a National Service Framework, designed to provide standards and models for the care of older people. Furthermore, recent moves to create strategic partnership agreements between the Department of Health, the NHS and the Voluntary and Community Sector point to increasing awareness of the interconnections between health and social care. However, even when services are in place, older people do not always use them. Understanding why this might be the case is key to further service planning and implementation.

In complex emergencies, especially those involving famine and/or wide-spread food insecurity, assessments of malnutrition are critical to understanding the population's health status and to assessing the effectiveness of relief interventions. Although the Democratic People's Republic of Korea (DPRK) has benefited from some of the largest, most sustained appeals in the history of the World Food Program (WFP), the government in Pyongyang has placed restrictions on international efforts to gather data on the health and nutritional status of the affected population.

Question: Lacking direct means to assess the nutritional status of the North Korean populace, what other methodologies could be employed to measure the public health impacts of chronic food shortage?

The paper begins with a review of methods for assessing nutritional status, particularly in emergencies; a brief history of the North Korean food crisis (1995–2001), and a review of the available nutritional and health data on the DPRK. The main focus of the paper is on the results of a survey of 2,692 North Korean adult migrants in China. Recognizing certain biases and limitations, the study suggests that sample households have experienced an overall decline in food security, as evidenced by both the decline in government rations from an average of 120 grams per person per day to less than 60 grams per day, and by the increase in the percentage of households relying on foraging or bartering of assets as their principal source of food. It also is apparent that the period 1995–1998 has been marked by elevated household mortality, declining fertility, and steadily rising out-migration. Taken together, the signs point toward famine, whether that is defined as a discrete event—that is, as a regional failure in food production or distribution leading to elevated mortality from starvation and associated disease—or as a more complex social process whose sub-states include not only elevated mortality, but declining fertility, eating of alternative ‘famine foods’, transfer of assets, and the uprooting and separation of families.

One of the more consistent characterizations of both American Fundamentalism and other versions of conservative Evangelicalism is that these groups represent authoritarian religious and social systems. Such characterizations are not entirely without some basis in fact. Fundamentalism will almost always appear authoritarian, and so too will forms of Pentecostalism which, like Fundamentalism, place a heavy emphasis on correct thinking and combine a belief in the infallibility of scripture with a commitment to literal readings. Outsiders are sometimes disconcerted to find that “authoritarian” and related concepts are not assessed negatively in conservative Evangelical circles. Quite the contrary is the case: the Bible, infallible, inerrant, “God-breathed,” is the clear center of Evangelical authority. Many a Fundamentalist sermon has sought to clinch its case with the phrase, “on authority of the holy Word of God.”

The political cohesiveness of religious groups varies widely. Some churches develop an almost complete identity with a political party or tendency while others exhibit a high degree of political pluralism. This paper explores some of the mechanisms that might account for the variability in political solidarity from one church to the next. On the basis of data from a survey of Protestant congregations, we find that cohesiveness around the norm of moral conservatism is associated with the same distinctive syndrome of traits that Dean Kelley has linked to church growth and vitality. “Strong” churches, defined by a combination of theology, social practices, and demographic characteristics, apparently possess the necessary resources to promote attitudinal conformity on some political issues.

Computer graphics systems that provide interactive display and manipulation of three-dimensional data are powerful tools for the analysis and communication of technical information required for characterization and design of a geologic repository for nuclear waste. Greater understanding of site performance and repository design information is possible when performance-assessment modeling results can be visually analyzed in relation to site geologic and hydrologic information and engineering data for surface and subsurface facilities. In turn, this enhanced visualization capability provides better communication between technical staff and program management with respect to analysis of available information and prioritization of program planning.

A commercially-available computer system was used to demonstrate some of the current technology for three-dimensional visualization within the architecture of information systems for nuclear waste management. This computer system was used to interactively visualize and analyze the information for two examples: 1) site-characterization and engineering data for a potential geologic repository at Yucca Mountain, Nevada; and 2) three-dimensional simulations of a hypothetical release and transport of contaminants from a source of radionuclides to the vadose zone. Users may assess the three-dimensional distribution of data and modeling results by interactive zooming, rotating, slicing, and peeling operations. For those parts of the database where information is sparse or not available, the software incorporates models for the interpolation and extrapolation of data over the three-dimensional space of interest.