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There is significant public health interest towards providing medical care at mass-gathering events. Furthermore, mass gatherings have the potential to have a detrimental impact on the availability of already-limited municipal Emergency Medical Services (EMS) resources. This study presents a cross-sectional descriptive analysis to report broad trends regarding patients who were transported from National Collegiate Athletic Association (NCAA) Division 1 collegiate football games at a major public university in order to better inform emergency preparedness and resource planning for mass gatherings.
Methods:
Patient care reports (PCRs) from ambulance transports originating from varsity collegiate football games at the University of Minnesota across six years were examined. Pertinent information was abstracted from each PCR.
Results:
Across the six years of data, there were a total of 73 patient transports originating from NCAA collegiate football games: 45.2% (n = 33) were male, and the median age was 22 years. Alcohol-related chief complaints were involved in 50.7% (n = 37) of transports. In total, 31.5% of patients had an initial Glasgow Coma Scale (GCS) of less than 15. The majority (65.8%; n = 48; 0.11 per 10,000 attendees) were transported by Basic Life Support (BLS) ambulances. The remaining patients (34.2%; n = 25; 0.06 per 10,000 attendees) were transported by Advanced Life Support (ALS) ambulances and were more likely to be older, have abnormal vital signs, and have a lower GCS.
Conclusions:
This analysis of ambulance transports from NCAA Division 1 collegiate football games emphasizes the prevalence of alcohol-related chief complaints, but also underscores the likelihood of more life-threatening conditions at mass gatherings. These results and additional research will help inform emergency preparedness at mass-gathering events.
The exercise of administrative discretion by street-level workers plays a key role in shaping citizens’ access to welfare and employment services. Governance reforms of social services delivery, such as performance-based contracting, have often been driven by attempts to discipline this discretion. In several countries, these forms of market governance are now being eclipsed by new modes of digital governance that seek to reshape the delivery of services using algorithms and machine learning. Australia, a pioneer of marketisation, is one example, proposing to deploy digitalisation to fully automate most of its employment services rather than as a supplement to face-to-face case management. We examine the potential and limits of this project to replace human-to-human with ‘machine bureaucracies’. To what extent are welfare and employment services amenable to digitalisation? What trade-offs are involved? In addressing these questions, we consider the purported benefits of machine bureaucracies in achieving higher levels of efficiency, accountability, and consistency in policy delivery. While recognising the potential benefits of machine bureaucracies for both governments and jobseekers, we argue that trade-offs will be faced between enhancing the efficiency and consistency of services and ensuring that services remain accessible and responsive to highly personalised circumstances.
The Variables and Slow Transients Survey (VAST) on the Australian Square Kilometre Array Pathfinder (ASKAP) is designed to detect highly variable and transient radio sources on timescales from 5 s to
$\sim\!5$
yr. In this paper, we present the survey description, observation strategy and initial results from the VAST Phase I Pilot Survey. This pilot survey consists of
$\sim\!162$
h of observations conducted at a central frequency of 888 MHz between 2019 August and 2020 August, with a typical rms sensitivity of
$0.24\ \mathrm{mJy\ beam}^{-1}$
and angular resolution of
$12-20$
arcseconds. There are 113 fields, each of which was observed for 12 min integration time, with between 5 and 13 repeats, with cadences between 1 day and 8 months. The total area of the pilot survey footprint is 5 131 square degrees, covering six distinct regions of the sky. An initial search of two of these regions, totalling 1 646 square degrees, revealed 28 highly variable and/or transient sources. Seven of these are known pulsars, including the millisecond pulsar J2039–5617. Another seven are stars, four of which have no previously reported radio detection (SCR J0533–4257, LEHPM 2-783, UCAC3 89–412162 and 2MASS J22414436–6119311). Of the remaining 14 sources, two are active galactic nuclei, six are associated with galaxies and the other six have no multi-wavelength counterparts and are yet to be identified.
We present the data and initial results from the first pilot survey of the Evolutionary Map of the Universe (EMU), observed at 944 MHz with the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. The survey covers
$270 \,\mathrm{deg}^2$
of an area covered by the Dark Energy Survey, reaching a depth of 25–30
$\mu\mathrm{Jy\ beam}^{-1}$
rms at a spatial resolution of
$\sim$
11–18 arcsec, resulting in a catalogue of
$\sim$
220 000 sources, of which
$\sim$
180 000 are single-component sources. Here we present the catalogue of single-component sources, together with (where available) optical and infrared cross-identifications, classifications, and redshifts. This survey explores a new region of parameter space compared to previous surveys. Specifically, the EMU Pilot Survey has a high density of sources, and also a high sensitivity to low surface brightness emission. These properties result in the detection of types of sources that were rarely seen in or absent from previous surveys. We present some of these new results here.
Lean development in France reflects in many ways the spread of lean all over the world, with some local specificities. France’s enduring national automotive industry had led very early pioneers to discover Toyota’s uniqueness and appreciate the transformative potential of the Toyota Production System (TPS) well before the term “lean” was coined. French companies then pursued the usual forms of lean, from “automotive” lean, to traditional consulting cost-saving programs disguised as lean, to genuine transformational efforts to understand and adapt the TPS in local conditions. Lean in France has also had some specific French offshoots, such as an obsession with “autonomous teams” and “liberated company” (Getz and Carney 2016), that can be traced to the socio-technical system approach of the Tavistock Institute. More recently, France stands out as the home of several CEOs that have adopted lean as their main business strategy, with very visible results in difficult market conditions and a high labor cost context. Lean and its application in French companies then seems to have become multifaceted, based on continuous and structured learning (Ballé et al. 2006), but also apprehended according to several theoretical frameworks to gradually lead to a richer understanding for researchers (Ballé et al. 2017). This chapter introduces the historical development of lean in France and, through an analysis of lean’s adoption, the three main “lean” perspectives of French companies.
We use ceramic and obsidian data from the ancient Maya port site of Vista Alegre to discuss long-distance exchange during the Terminal Classic (c. AD 850–1100) period. This is a time often associated with increased international trade relations and the growth of Chichen Itza as a dominant regional power in the northern Maya lowlands. Critical to the increased volume of international trade were the merchants who transported goods along the coast of Yucatan in large trading canoes. By combining a macroscopic assessment of the ceramics with visual, XRF, and INAA analyses of the obsidian artifacts, we gain insight into the various socioeconomic forces at work moving goods around the Peninsula. Given the paucity of Terminal Classic settlement in the interior Yalahau region, Vista Alegre appears to be an isolated site during this period, approximately 40 km from the nearest coastal neighbor. This allows us to focus on coastal exchange as the sole means by which goods arrived at the site. Our preliminary data contribute to the growing literature on the role market economies played in the Maya area, and the increased opportunities this afforded coastal peoples as circum-peninsular trade became more common through time.
Beusite-(Ca), ideally Ca${\rm Mn}_{\rm 2}^{2 +} $(PO4)2, is a new graftonite-group mineral from the Yellowknife pegmatite field, Northwest Territories, Canada. It occurs in a beryl–columbite–phosphate rare-element pegmatite where it is commonly intergrown with triphylite–lithiophilite or sarcopside, and may form by exsolution from a high-temperature (Li,Ca)-rich graftonite-like parent phase. It occurs as pale-brown lamellae 0.1–1.5 mm wide in triphylite, and is pale brown with a vitreous lustre and a very pale-brown streak. It is brittle, has a Mohs hardness of 5, and the calculated density is 3.610 g/cm3. Beusite-(Ca) is colourless in plane-polarized light, and is biaxial (+) with α = 1.685(2), β = 1.688(2), γ = 1.700(5), and the optic axial angle is 46.0(5)°. It is non-pleochroic with X || b; Y ˄ a = 40.3° in β obtuse; Z ˄ a = 49.7° in β acute. Beusite-(Ca) is monoclinic, has space group P21/c, a = 8.799(2), b = 11.724(2), c = 6.170(1) Å, β = 99.23(3)°, V = 628.3(1) Å3 and Z = 4. Chemical analysis by electron microprobe gave P2O5 41.63, FeO 19.43, MnO 23.63, CaO 15.45, sum 100.14 wt.%. The empirical formula was normalized on the basis of 8 anions pfu: (Ca0.94Fe0.92Mn1.13)Σ2.99(PO4)2.00. The crystal structure was refined to an R1 index of 1.55%. Beusite-(Ca) is a member of the graftonite group with Ca completely ordered at the [8]-coordinated M(1) site.
We discuss a generalisation of the synchrotron bubble model which has been applied to short-lived radio transients which can peak and decay over just a few days. The assumptions of the simple model imply that when the flux is increasing with time, it must also be an increasing function of frequency. Observations of two recent radio transients, Nova Muscae 1991 and the Galactic Centre Transient, include the first data showing such a rising phase, and in both cases the radio flux was a decreasing function of frequency during the observed rising phases. Thus the simple synchrotron bubble model is inadequate, at least for these events. A fundamental feature of the simple model is the assumption that the process accelerating the radiating electrons ceases before the radio emission can escape. We relax this assumption by including an injection of electrons, with a constant energy spectrum, into the synchrotron bubble.
Our objective was to review how meditation could comfort the terminally ill.
Method:
Our methodology was a literature search, which included books, journals, papers in collections, and online databases. The main search engines employed were Google Scholar and the Durham University Library. The main databases consulted were the Christian Meditation Centre, Project Meditation, and Stress-Related Facts and Well-Being at Monash. We were specifically interested in data acquired from clinical and nonclinical trials. The arguments needed to be based on qualitative and quantitative scientific data. Papers were published between 1985 and 2014. We then subdivided the review into three subcategories: physical, emotional, and self-awareness. When reviewing each category, we put our results into tabular form. In each table, we noted the percentage of terminally ill patients (TIPs) and non-terminally ill patients (NTIPs), and whether meditation had comforted them.
Results:
Our review demonstrated that there are many areas that have yet to be researched. First, very little work has been done on how meditation affects the physical health of TIPs, including such variables as blood pressure, chronic pain, and sleeping patterns. However, no research has been done on heart disease, hypertension, depression, among others. Second, virtually no research has been conducted on how meditation affects the mental health of TIPs. Notably neglected areas include anxiety, compliance, depression, and stress. Third, no research has been done on whether meditation increases self-awareness in TIPs. In each of these cases, most NTIPs reacted positively; however, no research has been done on why TIPs reacted differently.
Significance of Results:
Our results demonstrate the need for further research on how meditation affects terminally ill patients. In turn, this would enrich the debate on whether meditation should be prescribed for the dying.
Despite the historical difference in focus between AI planning techniques and Integer Programming (IP) techniques, recent research has shown that IP techniques show significant promise in their ability to solve AI planning problems. This paper provides approaches to encode AI planning problems as IP problems, describes some of the more significant issues that arise in using IP for AI planning, and discusses promising directions for future research.
Dogma discourages the provision of topical anesthetics to patients with corneal injuries discharged from the emergency department because of the toxicity of concentrated solutions. We compared the analgesic efficacy of dilute topical proparacaine with placebo in emergency department patients with acute corneal injuries.
Methods:
We conducted a prospective randomized controlled trial of adults with corneal injuries presenting to one of 2 tertiary care emergency departments in London, Ont. Patients were randomly assigned to groups receiving either 0.05% proparacaine or placebo drops as outpatients and were followed up to healing by a single ophthalmologist. Our primary outcome was pain reduction as measured on a 10-cm visual analog scale.
Results:
Fifteen participants from the proparacaine group and 18 participants from the placebo group completed the study. The mean age of the patients was 38.7 (standard deviation 12.3) years and the majority were male (85%). Pain reduction was significantly better in the proparacaine group than in the placebo group, with a median improvement of 3.9 (interquartile range [IQR] 1.5–5.1 ) cm on the visual analog scale versus a median improvement of 0.6 (IQR 0.2–2.0) cm (p = 0.007). The proparacaine group was more satisfied (median level of satisfaction 8.0 [IQR 6.0–9.0] cm on a 10-cm visual analog scale v. 2.6 [IQR 1.0–8.0] cm, p = 0.027). There were no ocular complications or signs of delayed wound healing in either group.
Conclusion:
Dilute topical proparacaine is an efficacious analgesic for acute corneal injuries. Although no adverse events were observed in our study population, larger studies are required to evaluate safety.
Responding to the sustained interest in and controversial discussion of the prospects of hydrogen, this book strives to reflect on the perspectives of a hydrogen economy in light of the global energy challenge, in particular the question of how to meet the growing demand for transport energy in the long term and how to secure sustainable energy for transportation. This book stands out from other publications by its emphasis on setting the scene for hydrogen, and the comprehensive coverage of all aspects related to the hydrogen subject. It aims to provide a reference and compendium about hydrogen that should be of interest to anyone who wants to catch up on the status of the hydrogen discussion, look up a specific aspect related to hydrogen, or understand how hydrogen comes off compared to other mobility solutions. The book should appeal to a fairly broad readership: academia, policy makers and industry.