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After the rapid implementation of digital health services during the COVID-19 pandemic, a paucity of research exists about the suitability of remote consulting in people with intellectual disabilities and their carers, particularly for neuropsychiatric reviews.
Aim
This study examines when remote neuropsychiatric routine consulting is suitable for this population.
Method
A survey was conducted of people with intellectual disabilities and their carers, examining their preference between face-to-face and video consultations for ongoing neuropsychiatric reviews within a rural countywide intellectual disability service in Cornwall, England (population: 538 000). The survey was sent to all adults with intellectual disabilities open to the service on 30 July 2022, closing on 30 September 2022. Participants were asked to provide responses on 11 items predesigned and co-produced between clinicians and experts by experience. The entire service caseload of people had White ethnicity, reflecting the ethnic demographics of Cornwall. Responses received without consent were excluded from the study dataset.
Results
Of 271 eligible participants, 119 responses were received, 104 of whom consented to having their anonymised data used for research analysis. There were no significant differences between preferences and age and gender variables. There was no statistically significant difference regarding preference for the reintroduction of face-to-face appointments (52.0%) compared with video consultations (48.0%). Travel distance (>10 miles) to the clinical setting was important but did not outweigh benefits for those preferring a face-to-face appointment.
Conclusions
This study offers insights into the factors that influence preferences about what type of neuropsychiatric appointment is most suitable for people with intellectual disabilities.
Due to shortages of N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic, it is necessary to estimate the number of N95s required for healthcare workers (HCWs) to inform manufacturing targets and resource allocation.
Methods:
We developed a model to determine the number of N95 respirators needed for HCWs both in a single acute-care hospital and the United States.
Results:
For an acute-care hospital with 400 all-cause monthly admissions, the number of N95 respirators needed to manage COVID-19 patients admitted during a month ranges from 113 (95% interpercentile range [IPR], 50–229) if 0.5% of admissions are COVID-19 patients to 22,101 (95% IPR, 5,904–25,881) if 100% of admissions are COVID-19 patients (assuming single use per respirator, and 10 encounters between HCWs and each COVID-19 patient per day). The number of N95s needed decreases to a range of 22 (95% IPR, 10–43) to 4,445 (95% IPR, 1,975–8,684) if each N95 is used for 5 patient encounters. Varying monthly all-cause admissions to 2,000 requires 6,645–13,404 respirators with a 60% COVID-19 admission prevalence, 10 HCW–patient encounters, and reusing N95s 5–10 times. Nationally, the number of N95 respirators needed over the course of the pandemic ranges from 86 million (95% IPR, 37.1–200.6 million) to 1.6 billion (95% IPR, 0.7–3.6 billion) as 5%–90% of the population is exposed (single-use). This number ranges from 17.4 million (95% IPR, 7.3–41 million) to 312.3 million (95% IPR, 131.5–737.3 million) using each respirator for 5 encounters.
Conclusions:
We quantified the number of N95 respirators needed for a given acute-care hospital and nationally during the COVID-19 pandemic under varying conditions.
Optical tracking systems typically trade off between astrometric precision and field of view. In this work, we showcase a networked approach to optical tracking using very wide field-of-view imagers that have relatively low astrometric precision on the scheduled OSIRIS-REx slingshot manoeuvre around Earth on 22 Sep 2017. As part of a trajectory designed to get OSIRIS-REx to NEO 101955 Bennu, this flyby event was viewed from 13 remote sensors spread across Australia and New Zealand to promote triangulatable observations. Each observatory in this portable network was constructed to be as lightweight and portable as possible, with hardware based off the successful design of the Desert Fireball Network. Over a 4-h collection window, we gathered 15 439 images of the night sky in the predicted direction of the OSIRIS-REx spacecraft. Using a specially developed streak detection and orbit determination data pipeline, we detected 2 090 line-of-sight observations. Our fitted orbit was determined to be within about 10 km of orbital telemetry along the observed 109 262 km length of OSIRIS-REx trajectory, and thus demonstrating the impressive capability of a networked approach to Space Surveillance and Tracking.
The purpose of this study was to describe Canadian contextual trends in pediatric firearm injuries and death from powder and non-powder firearms.
Methods
This is a registry study of firearm-related injuries captured by the Canadian Hospitals Injury and Reporting Prevention Program (CHIRPP) for children ages 0 to 18 years presenting to participating CHIRPP emergency departments (EDs) from 2006 to 2013. Data included age, sex, year, setting, circumstance, and disposition for each case.
Results
The CHIRPP dataset included 325 non-powder firearm injuries and 80 powder gun injuries. The rate of firearm injuries remained stable from 2006 to 2013 (44 per 100,000 ED visits). Forty-five patients required hospital admission and 2 died in the ED; 8 of 9 intentional self-harm injuries were inflicted with a powder gun. Most injuries occurred unintentionally from non-powder firearms (n=298, 71%) in the context of recreation (n=179) and sport (n=48). Eyes were the most commonly injured body part (n=150), 98% of which resulted from a non-powder firearm. Forty-three percent (n=141) of non-powder firearm injuries required treatment or admission.
Conclusions
Eye injuries inflicted by non-powder firearms are a prevalent category of firearm-related injury. Most occurred through recreation and sport, highlighting a potential focus for primary prevention.
The invasive annual grass downy brome is the most ubiquitous weed in sagebrush systems of western North America. The center of invasion has largely been the Great Basin region, but there is an increasing abundance and distribution in the Rocky Mountain States. We evaluated postfire vegetation change using very large–scale aerial (VLSA) and near-earth imagery in an area where six different fires occurred over a 4-yr period at elevations ranging from 1,900 to over 2,700 m. The frequency of downy brome increased from 8% in 2003 to 44% in 2008 and downy brome canopy cover increased from < 1% in 2003 to 6% in 2008 across the entire study area. Principal component analyses of vegetation cover indicate a shift from plant communities characterized by high bare soil and forbs immediately postfire to communities with increasing downy brome cover with time after fire. The highest-elevation sampling area exhibited the least downy brome cover, but cover at some midelevation locations approached 100%. We postulate that the loss of ground-level shade beneath shrubs and conifers, accompanied by diminished perennial vegetative cover, created conditions suitable for downy brome establishment and dominance. Without a cost-effective means of landscape-scale downy brome control, and with infestation levels and climate warming increasing, we predict there will be continued encroachment of downy brome at higher elevations and latitudes where disturbance creates suitable conditions.
This paper explains securitization of insurance risk by describing its essential components and its economic rationale. We use examples and describe recent securitization transactions. We explore the key ideas without abstract mathematics. Insurance-based securitizations improve opportunities for all investors. Relative to traditional reinsurance, securitizations provide larger amounts of coverage and more innovative contract terms.
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