bluuebunny/crossref_metadata_2025 huggingface dataset:
Notes about Terminology and Nomenclature
Authors: Kurti N.
Published: July 2016

There seems to be a disturbing rate of increase in new scientific and technical terms. The purpose of these notes is to stimulate a discussion of this trend.

When inventing or introducing new terms the following points should be borne in mind: (1) is a new word necessary or desirable, (2) is it apt and well-constructed?

As regards (1) the usual justification is that science and engineering are developing so fast that in order to communicate new ideas and new concepts an increase in the vocabulary is essential. This, however, can be overdone. The very act of coining a new word implies a theoretical assessment, almost an acknowledgment of the fact that a concept or phenomenon, or particle has a well defined identity. The following, somewhat exaggerated examples, illustrate this point. It would have been most unfortunate if spectroscopists at the end of the last century had insisted on giving one and the same chemical element different names according to the wavelength of the light they emitted. I wonder whether the many names allocated to elementary particles today may not become an embarrassment should it turn out that they are in many cases just excited states of one and the same particle. Conversely, one must applaud the restraint of the nuclear physicists for not giving separate names to various radioactive isotopes. After all, as far as nuclear properties go, many isotopes (e.g.57Co, 58Co, 60Co) have very little in common. And, although we have a separate name for the heavy hydrogen isotope (deuterium), physicists and chemistsi have so far resisted the temptation to give the light isotope of helium (3He) a name and we are still spared “trelium”.
Instruments and Equipment for Testing
Authors: Bingham A. E.
Published: July 2016

Just after the turn of the century, after many struggles, the heavier-than-air flying machine first rose from the earth, part of the success being due to the development of the comparatively light internal combustion engine. The materials of the airframe being mainly wood, including bamboo, and a few pieces of mild steel plate.

For a few years the materials of construction altered only a little and the knowledge of those materials and their behaviour was limited and confined to that which had been established during the course of mechanical engineering.

The mechanical engineers had been able to include fairly substantial factors of safety in their calculations which covered many variations and possible errors in materials, loads and workmanship and also—probably unknowingly —problems which could arise from fatigue.
The First Ten Years
Authors: Green F. M.
Published: July 2016

The Royal Aeronautical Society has a history of 100 years. I can look back over a membership of more than half that time, since I was made a Fellow in 1911.

My start in the aeronautical world began in 1910. I was appointed Engineer in charge of Design at Farn-borough by its chief, Mervyn O'Gorman. He was a far-sighted and inspiring man, under whom it was a pleasure to work. The War Office had lost faith in aeroplanes and our work was to be confined to lighter-than-air craft. Sam Hiscocks was the able chief draughtsman of a very small drawing office with whose help we managed to make three airships. The latest was called the Delta, and had a speed of 45 miles an hour. This may seem absurdly slow but it was faster than many aeroplanes flying at the time. The Delta was eventually taken over by the Naval Air Service and was used for submarine spotting during the First World War.
Lift Characteristics of Asymmetric Exhaust Nozzles at High
Flight Speeds
Authors: Lewis W. G. E. , Herd R. J. , Herbert M. V.
Published: July 2016

If a supersonic nozzle is designed for less than complete expansion of the flow, some lift force can be produced without downwards deflection of the nozzle. A theoretical analysis has been made, by the method of characteristics, for a two-dimensional nozzle consisting of an upper wedge and lower parallel shroud. General trends of lift performance with the main variables have been obtained.
Resurrecting the chimera: Progressions in parenting and peer processes
Authors: Forgatch Marion S. , Snyder James J. , Patterson Gerald R. , Pauldine Michael R. , Chaw Yvonne , Elish Katie , Harris Jasmine B. , Richardson Eric B.
Published: July 2016

This report uses 6-year outcomes of the Oregon Divorce Study to examine the processes by which parenting practices affect deviant peer association during two developmental stages: early to middle childhood and late childhood to early adolescence. The participants were 238 newly divorced mothers and their 5- to 8-year-old sons who were randomly assigned to Parent Management Training—Oregon Model (PMTO®) or to a no-treatment control group. Parenting practices, child delinquent behavior, and deviant peer association were repeatedly assessed from baseline to 6 years after baseline using multiple methods and informants. PMTO had a beneficial effect on parenting practices relative to the control group. Two stage models linking changes in parenting generated by PMTO to children's growth in deviant peer association were supported. During the early to middle childhood stage, the relationship of improved parenting practices on deviant peer association was moderated by family socioeconomic status (SES); effective parenting was particularly important in mitigating deviant peer association for lower SES families whose children experience higher densities of deviant peers in schools and neighborhoods. During late childhood and early adolescence, the relationship of improved parenting to youths' growth in deviant peer association was mediated by reductions in the growth of delinquency during childhood; higher levels of early delinquency are likely to promote deviant peer association through processes of selective affiliation and reciprocal deviancy training. The results are discussed in terms of multilevel developmental progressions of diminished parenting, child involvement in deviancy producing processes in peer groups, and increased variety and severity of antisocial behavior, all exacerbated by ecological risks associated with low family SES.
Understanding the interplay of individual and social–developmental factors in the progression of substance use and mental health from childhood to adulthood
Authors: Jones Tiffany M. , Hill Karl G. , Epstein Marina , Lee Jungeun Olivia , Hawkins J. David , Catalano Richard F.
Published: July 2016

This study examines the interplay between individual and social–developmental factors in the development of positive functioning, substance use problems, and mental health problems. This interplay is nested within positive and negative developmental cascades that span childhood, adolescence, the transition to adulthood, and adulthood. Data are drawn from the Seattle Social Development Project, a gender-balanced, ethnically diverse community sample of 808 participants interviewed 12 times from ages 10 to 33. Path modeling showed short- and long-term cascading effects of positive social environments, family history of depression, and substance-using social environments throughout development. Positive family social environments set a template for future partner social environment interaction and had positive influences on proximal individual functioning, both in the next developmental period and long term. Family history of depression adversely affected mental health functioning throughout adulthood. Family substance use began a cascade of substance-specific social environments across development, which was the pathway through which increasing severity of substance use problems flowed. The model also indicated that adolescent, but not adult, individual functioning influenced selection into positive social environments, and significant cross-domain effects were found in which substance-using social environments affected subsequent mental health.
Transactional effects among maternal depression, neighborhood deprivation, and child conduct problems from early childhood through adolescence: A tale of two low-income samples
Authors: Shaw Daniel S. , Sitnick Stephanie L. , Reuben Julia , Dishion Thomas J. , Wilson Melvin N.
Published: July 2016

The current study sought to advance our understanding of transactional processes among maternal depression, neighborhood deprivation, and child conduct problems (CP) using two samples of low-income families assessed repeatedly from early childhood to early adolescence. After accounting for initial levels of negative parenting, independent and reciprocal effects between maternal depressive symptoms and child CP were evident across both samples, beginning in early childhood and continuing through middle childhood and adolescence. In addition, neighborhood effects were consistently found in both samples after children reached age 5, with earlier neighborhood effects on child CPandmaternal depression found in the one exclusively urban sample of families with male children. The results confirm prior research on the independent contribution of maternal depression and child CP to the maintenance of both problem behaviors. The findings also have implications for designing preventative and clinical interventions to address child CP for families living in high-risk neighborhoods.
Sexually dimorphic and interactive effects of prenatal maternal cortisol and psychological distress on infant cortisol reactivity
Authors: Giesbrecht Gerald F. , Letourneau Nicole , Campbell Tavis S. ,   The Alberta Pregnancy Outcomes and Nutrition Study Team
Published: July 2016

In utero exposure to maternal psychological distress is a risk factor for developmental psychopathology, and these effects are believed to partially occur via dysregulation of the maternal and fetal hypothalamus–adrenal–pituitary axes. Nevertheless, only a few human studies have directly assessed the effects of prenatal cortisol exposure on infant cortisol reactivity, and none have investigated sex differences or potential interactions between prenatal cortisol and psychological distress. Here we report on a prospective longitudinal investigation (N = 236) of in utero exposure to maternal cortisol and distress in a relatively high socioeconomic status and low-risk population to determine whether these exposures interact in their effects on infant (M age = 3.0 months, range = 2.3–5.0 months, 51.9% male) cortisol reactivity and whether there are sex differences in these effects. Results revealed both sexually dimorphic and interactive effects of prenatal cortisol and distress, even after controlling for postnatal distress. In general, blunted reactivity in females was associated with exposure to high maternal distress and flattened patterns of diurnal maternal cortisol, whereas blunted reactivity in males was associated with exposure to steeper morning increases and daytime decreases in maternal cortisol. The findings suggest that sex differences in the effects of prenatal cortisol and distress on infant cortisol reactivity are a plausible mechanism by which maternal experiences during pregnancy contribute to sex differences in the development of psychopathology.
Prenatal maternal depression and child serotonin transporter linked polymorphic region (5-HTTLPR) and dopamine receptor D4 (DRD4) genotype predict negative emotionality from 3 to 36 months
Authors: Green Cathryn Gordon , Babineau Vanessa , Jolicoeur-Martineau Alexia , Bouvette-Turcot Andrée-Anne , Minde Klaus , Sassi Roberto , St-André Martin , Carrey Normand , Atkinson Leslie , Kennedy James L. , Steiner Meir , Lydon John , Gaudreau Helene , Burack Jacob A. , Levitan Robert , Meaney Michael J. , Wazana Ashley ,   The Maternal Adversity, Vulnerability, and Neurodevelopment Research Team
Published: July 2016

Prenatal maternal depression and a multilocus genetic profile of two susceptibility genes implicated in the stress response were examined in an interaction model predicting negative emotionality in the first 3 years. In 179 mother–infant dyads from the Maternal Adversity, Vulnerability, and Neurodevelopment cohort, prenatal depression (Center for Epidemiologic Studies Depressions Scale) was assessed at 24 to 36 weeks. The multilocus genetic profile score consisted of the number of susceptibility alleles from the serotonin transporter linked polymorphic region gene (5-HTTLPR): no long-rs25531(A) (LA: short/short, short/long-rs25531(G) [LG], or LG/LG] vs. any LA) and the dopamine receptor D4 gene (six to eight repeats vs. two to five repeats). Negative emotionality was extracted from the Infant Behaviour Questionnaire—Revised at 3 and 6 months and the Early Child Behavior Questionnaire at 18 and 36 months. Mixed and confirmatory regression analyses indicated that prenatal depression and the multilocus genetic profile interacted to predict negative emotionality from 3 to 36 months. The results were characterized by a differential susceptibility model at 3 and 6 months and by a diathesis–stress model at 36 months.
Differential associations of threat and deprivation with emotion regulation and cognitive control in adolescence
Authors: Lambert Hilary K. , King Kevin M. , Monahan Kathryn C. , McLaughlin Katie A.
Published: July 2016

Research on childhood adversity has traditionally focused on single types of adversity, which is limited because of high co-occurrence, or on the total number of adverse experiences, which assumes that diverse experiences influence development similarly. Identifying dimensions of environmental experience that are common to multiple types of adversity may be a more effective strategy. We examined the unique associations of two such dimensions (threat and cognitive deprivation) with automatic emotion regulation and cognitive control using a multivariate approach that simultaneously examined both dimensions of adversity. Data were drawn from a community sample of adolescents (N = 287) with variability in exposure to violence, an indicator of threat, and poverty, which is associated with cognitive deprivation. Adolescents completed tasks measuring automatic emotion regulation and cognitive control in neutral and emotional contexts. Violence was associated with automatic emotion regulation deficits, but not cognitive control; poverty was associated with poor cognitive control, but not automatic emotion regulation. Both violence and poverty predicted poor inhibition in an emotional context. Utilizing an approach focused on either single types of adversity or cumulative risk obscured specificity in the associations of violence and poverty with emotional and cognitive outcomes. These findings suggest that different dimensions of childhood adversity have distinct influences on development and highlight the utility of a differentiated multivariate approach.
Health-Related Relief in the Former Yugoslavia: Needs, Demands, and Supplies
Authors: Rubin Margareta , Heuvelmans J. Hans A. , Tomic-Cica Anja , Birnbaum Marvin L.
Published: July 2016

Introduction:

Many organizations rally to areas to provide assistance to a population during a disaster. Little is known about the ability of the materials and services provided to meet the actual needs and demands of the affected population. This study sought to identify the perceptions of representatives of the international organizations providing this aid, the international workers involved with the delivery of this aid, the workers who were employed locally by the international organizations, the recipients, and the local authorities. This study sought to identify the perceptions of these personnel relative to the adequacies of the supplies in meeting the needs and demands of the population during and following the war in Bosnia-Herzegovina.

Methods:

Structured interviews were conducted with representatives of international organizations and workers providing aid and with locally employed workers, recipients of the assistance, and the authorities of the areas involved. Descriptive and inferential statistics were used to assist in the analysis of the data.

Results:

Eighty-eight interviews were conducted. A total of 246 organizations were identified as providing assistance within the area, and 54% were involved with health-related activities including: 1) the provision of medications; 2) public health measures; and 3) medical equipment or parts for the same. Internationals believed that a higher proportion of the needs were being met by the assistance (73.4 ±16.4%) than did the nationals (52.1 ±23.3%; p <0.001). All groups believed that approximately 50% of the demands of the affected population were being addressed. However, 87% of the international interviewees believed that the affected population was requesting more than it actually needed.

While 27% of the international participants believed that ≥25% of what was provided was unusable, 80% of the recipients felt that ≥25% of the provisions were not usable. Whereas two-thirds of the international participants believed that ≥25% of the demands for assistance by the affected community could not be justified, only 20% of the recipients and authorities believed ≥25% of the demands were unjustified.

Conclusions::

Many organizations are involved in the provision of medical assistance during a disaster. However, international organizations and workers believe their efforts are more effective than do the recipients.
Cardiovascular Mortality — The Hidden Peril of Heat Waves
Authors: Wainwright Sherrilyn H. , Buchanan Sharunda D. , Mainzer Hugh M. , Parrish R. Gibson , Sinks Thomas H.
Published: July 2016

Objective:

Define the mortality associated with extremely hot weather during the 04 July through 14 July, 1993 heat wave that struck the northeastern United States.

Methods:

Design — A rapid field assessment was used to compare mortality occurring during the heat wave to mortality occurring during a period in which there was no heat wave using copies of death certificates, The findings of the rapid field assessment were validated, and it was determined whether increases in mortality occurred in other metropolitan east-coast counties also affected by the heat wave, by reviewing computerized mortality files.

Setting — Information was collected on all deaths occurring in Baltimore City, Maryland; Baltimore County, Maryland; Essex County, New Jersey; Newcastle County, Delaware; and Philadelphia County, Pennsylvania; during these specified study periods: 08 – 18 June (comparison period) and 06 – 16 July (heat wave study period), 1993.

Main Outcome Measures — Ratios for total mortality, cause-specific mortality, and variables such as age, sex, race, residence, and day and place of death, that were available fiom death certificates were calculated.

Results:

From the rapid field assessment, the following were observed: a 26% increase in total mortality and a 98% increase in cardiovascular mortality associated with the heat wave in Philadelphia. Data from the computerized mortality files showed an increase in total mortality in four of five counties examined and an increase in cardiovascular mortality in all five counties. The risk for death for those dying from cardiovascular disease increased significantly for people older than 64 years, for both sexes, and all races.

Conclusion:

As initially indicated by the Philadelphia Medical Examiner, there was excess mortality associated with a heat wave in Philadelphia. All other nearby counties examined also experienced excess mortality associated with the heat wave, although this excess was not recognized by the local health officials. The true impact of a heat wave that causes excess preventable mortality must be appropriately and rapidly ascertained. Using a national standard to certify a death as heat-related will provide the needed information rapidly so that public health resources can be more effectively allocated and mobilized to prevent further heat-related illnesses and death.
Field Epidemiology Assessment for a Medical Evacuation Programme Related to the Crisis in Kosovo, 1999
Authors: MacPherson Douglas W. , Mariani Fausto , Weekers Jacqueline , Gushulak Brian D.
Published: July 2016

In complex human emergency (CHE)-aid situations, the international community responds to provide assistance to reduce morbidity and mortality related to environmental and civil disruptions. The political and social situation in Kosovo, in combination with the military activity from 23 March to 09 June, 1999, created a crisis associated with mass movement of the population of Kosovo into neighbouring provinces and nations. This forced migration of people seeking protection increased demands for -water, food, shelter, and health care in the refugee areas. The United Nations High Commission for Refugees (UNHCR) estimated that 771,900 ethnic Albanians, and 30,700 Serbians, Croatians, and Montenegrins had been displaced from Kosovo during this time period, and that 439,500 of these people had arrived in Albania. Given the limited health-care resources in Albania to respond to the increasing demands for health care, a field epidemiological study was conducted by the International Organization for Migration (IOM) to assess the need for a medical evacuation program from Albania related to the crisis in Kosovo. Outcome measurements in this assessment were: 1) health-care capacity and health-care utilization rates in Albania before the crisis and by the refugees during the crisis; 2) the frequency of war-related injuries; 3) the frequency of medical evacuation; 4) nature of medical conditions of the patients being evacuated; and 5) destination for medical evacuation (internal or international) during the crisis. The results of the field assessment, which gathered health outcome data during the first eight weeks of the conflict (23 March 1999 to 25 May 1999), indicated that there was a need for a specifically designed medical evacuation programme in Albania. The study demonstrated that the implementation of a medical evacuation programme must be integrated with the national health care objectives. It also was found that the magnitude of an evacuation programme could be reduced markedly by strategic support of existing medical programmes in Albania (haemodialysis, trauma and orthopaedics, blood banking). Implementation of this strategy could permit containment of the majority of cases within Albania or to regional, health-care facilities. The results of such targeted support for specific services could result in a national programme for internal medical evacuation, with limited dependence upon the international movement of patients.
Cerebral Resuscitation
Authors: Hogya Paul T. , Harpe Keith G.
Published: July 2016

Resuscitology is the science of reanimation from apparent death or from unconsciousness. Prior to the last quarter of this century, resuscitation was steeped in myth, supported only by anecdote, and founded on unphysiologic principles. The development of new, scientifically based, modern concepts and practice of cardiopulmonary resuscitation (CPR) injected great hope into improving the chances for survival and quality of life for cardiac patients.

Recent reports indicate that there are nearly 70,000 “successful” cardiac resuscitations annually. However, it is estimated that only 10% are able to resume their former lifestyles. It is anticipated that with the expansion of prehospital emergency medical services, this proportion will increase. These facts have stimulated intense research aimed at elucidating the pathophysiology of cellular death with the goal of protecting the brain during cardiac arrest.
Delayed Perforation of the Intestine after Abdominal Trauma—A Case of Complications in Major Trauma Cases
Authors: Johansson L. , Jonsson A. , Lennquist S. , Nystrom P.-O , Norrby K.
Published: July 2016

The mortality rate for penetrating trauma of the abdomen has declined to a present rate of approximately 10%. However, blunt abdominal trauma still carries a high mortality, in some reports up to 30%. This is due mainly to major trauma with a resulting slow onset of symptoms sometimes resulting in a delay in diagnosis and treatment. One possible cause of delayed symptomatology after abdominal trauma could be delayed perforation of intestinal wall hemorrhages. A survey of the literature on this type of intestinal lesion was done in 1977 by Hughes et al, who found 260 clinical reports of intestinal wall hematomas.
Field Decontamination and Triage in Chemical Emergencies
Authors: Doyle Constance J.
Published: July 2016

Triage and rescue of casualties from accidents involving hazardous materials is a challenge for many emergency medical services (EMS) personnel. With very toxic materials, the untrained and unprepared rescuer may become a victim. In addition, few hospitals in the United States have decontamination units attached to their emergency departments and emergency department personnel may become exposed if the casualty is not decontaminated. Many environmental cleanup teams, including the U.S. Environmental Protection Agency (EPA) team, are well trained in materials handling but are not immediately available when a hazardous materials spill with personal injuries occurs.
Case Report: Utilization of a Phased Response Disaster Plan
Authors: Prescott John E. , Slay Robert D. , Dice William H.
Published: July 2016

The traditional hospital disaster plan is complex and inefficient. Implementation during an actual or perceived crisis usually results in the mobilization of the entire hospital staff and multiple medical resources. This “all or none” phenomenon is costly in terms of manpower and supplies. Furthermore, there is protracted disruption of normal hospital services during disaster plan activation for training or real emergencies.
Swedish Civilian Planning for Anesthesia in Peace Time, Crises and War
Authors: Norberg Karl-Axel , Dalenius Eskil , Hallen Borje
Published: July 2016

In recent years, medical care in Sweden as in other small countries, has become increasingly dependent upon the availability of imported goods. The consequences of even limited import restrictions of drugs and supplies has necessitated special planning for such a contingency. Special difficulties in this respect would arise in the field of anesthesia and intensive care, as all drugs for general anesthesia, and almost all disposable items used in anesthesia and intensive care in Sweden, are imported. To solve this problem, it would be necessary to ration drugs and materials, increase domestic production, introduce resterilization of disposable equipment and again use nondisposable supplies. In addition, stores of drugs and supplies are being built up to be used as a reserve in case of blockade or war. The nursing standards would have to be changed, by delegation to other personnel so that nurses take a larger responsibility, and by using methods which are unusual or even unknown to the staff in service today, i.e. ether anesthesia.
Earthquake Prediction
Authors: Karnik Vit
Published: July 2016

Every new earthquake disaster revives the idea of earthquake prediction, the idea which was considered a few decades ago as a fantasy scientific endeavor. However, recent technical and scientific developments, as well as some social and economic pressures, have created a quite different atmosphere. Earthquake prediction has become a serious scientific activity combining the efforts and results of many disciplines, particularly those of the earth sciences. The principal purpose of earthquake prediction is to reduce the vulnerability of the population living within an earthquake prone region. For this reason, scientific disciplines other than seismology and geology are also involved; they include those dealing with various aspects of human response and environment.
Decompression Sickness Damaging the Spinal Cord in a Scuba Diver: Case Report
Authors: Mathew B.G.
Published: July 2016

Scuba diving has become a popular sport resulting in an increased incidence of diving accidents. A survey done by the United States Navy from 1955 to 1960 revealed that decompression sickness (D.C.S.) is the most common serious complication experienced by scuba divers and the third most likely cause of death. The major cause is drowning and the second is arterial gas embolism from pulmonary barotrauma.

D.C.S. has been classified into two groups. Type I includes the less severe forms with bubbles in the skin (“itches”), joints and other tissues. Type II includes the serious conditions with neurological involvement “staggers.” A detailed knowledge of D.C.S., commonly known as “the bends,” is essential to both divers and emergency personnel in order to minimize the morbidity and mortality associated with this condition.

A case of Type II bends with spinal cord damage is presented and the condition discussed.
Oxygen via the Peritoneum
Authors: Faithfull N.S. , Salt P.J. , Klein J. , Soini H. , van der Zee H. , Erdmann W.
Published: July 2016

Perfluorochemicals (PFCs), which are also known as fluorocarbons or perfluorocarbons, are chemical substances having a high solubility for respiratory gases. At 37 degrees Centigrade pure PFCs can dissolve very large quantities of oxygen and in some instances this may amount to as much as 50 volumes %. These substances are however immiscible with blood and if introduced into the circulation in an unmodified form could cause embolic phenomena. In order to be of use as oxygen carrying blood substitutes, they are therefore emulsified in a solution containing glucose, electrolytes and an osmotic agent.
The New “Journal of the World Association for Emergency and Disaster Medicine” (J. WAEDM)
Authors: Safar Peter
Published: July 2016

This new Journal, starting with volume 1, number 1, Spring 1985, is an official publication of the World Association for Emergency and Disaster Medicine (WAEDM), formerly called the Club of Mainz. The Journal is cosponsored by the League of Red Cross and Red Crescent Societies (LRCS). The Journal is owned and published by the WAEDM. There will be 4 Journal numbers per year.
The Role of the Military in International Military-Civilian Collaboration for Disaster Medicine in the USA
Authors: Bisgard Jay C.
Published: July 2016

The United States Military Health Care System exists primarily to ensure the ready availability of medical support to U.S. Armed Forces at any level of conflict anywhere in the world. Many military medical units are therefore organized and equipped to permit their rapid deployment on short warning to relatively remote areas. They can provide life-saving services within hours and can operate almost independently in any climate, provided they have the means to evacuate patients and to receive supplies. The military mission demands that the medical personnel assigned to these units be trained in peacetime to do their jobs in wartime.
Cooperation Between Developing and Industrialized Countries in Disaster Relief
Authors: Weyand Jurgen
Published: July 2016

A disaster may be defined, for this paper, as “a situation in which an urgent need arises for international assistance to relieve humansuffering.” Disasters are frequently divided into manmade and natural disasters. Many so-called natural disasters have, however, a considerable manmade component in their etiology. The number of people vulnerable to the effects of disasters is increasing, and in the future disasters affecting human beings are likely to occur with greater frequency and severity, Full account must also be taken of the effects of a rapidly expanding world population, of advances in science and technology, and of economic and ecological factors.
Physician-Staffed Helicopter Ambulance Service in Norway
Authors: Moe Jens , Skole Erling W.
Published: July 2016

There are high mountains around Oslo, which is located at the foot of the Oslo Fjord. The winter is rough, with snowstorms and secondary roads often closed, and people often ski long distances. Avalanches have buried many people. We started a physician-staffed ambulance helicopter service on June 1, 1978 out of the Central Hospital of Akershus, Oslo, primarily to get a physician to the scene as soon as possible. The helicopter is on alert 24 h a day and can take off in 2 min in the daytime and 15 min at night. In 86% of the cases, the helicopter can land within 50 m of the patient. At night, the landing places have to be more secure. The helicopter is a Bolkow BO 105, which can carry 2 patients, 1 pilot, 1 rescuer or paramedic, and 1 physician. In case of an accident on a lake, the paramedic is a frogman and in case of an avalanche we take a specially trained dog along. The pilot has vase experience with helicopter duty, and the paramedic has good medical and rescue experience. The physician has to be a specialist in emergency medicine and is usually an anesthesiologist. The team is always on duty at the hospital where the helicopter is stationed, only 100 m from the emergency entrance of the hospital.
The Cadre of Death Education Instructors in Paramedic Programs
Authors: Smith Tracy L. , Walz Bruce J.
Published: July 2016

Objective:

This study addresses the paucity of literature on death education offerings in emergency medical services schools. The study examines the cadre of death education instructors in paramedic training programs. Examining death education offerings in paramedic programs can provide insight into how well emergency medical services personnel are prepared when encountering bereaved persons on death related responses.

Methods:

In an exploratory study, information was gathered from paramedic programs on the instructors who teach death-related education. A self-administered survey was sent to each (n = 537) paramedic programs in the USA. The survey solicited the number of instructors teaching death education, their backgrounds, and their formal training in death-related instruction.

Results:

The response rate was 45.4%. The majority of programs (78%) reported using a paramedic as the primary instructor to teach death-related content. Nurses (66%) and physicians (32%) also were utilized frequently. More than two-thirds (68%) of the responding programs utilize faculty members who have had no formal training in death and dying. Only one-third of the programs utilizes a multidisciplinary staff Less than 40% of responding programs teach all of their death-related curricula with instructors who are trained in death education.

Conclusion:

This study indicates that the majority of paramedic programs are not utilizing an instructor cadre that is formally trained in death education, nor are they using a multidisciplinary staff. Reasons for using these instructors to teach death education in paramedic programs are discussed.
The Tale of the Tragedy of Neftegorsk
Authors: Johnson Mark S.
Published: July 2016

An earthquake with a magnitude of 7.6 struck the town of Neftegorsk (population about 3,000) on 27 May, 1995. This paper describes the devastation and the human aspects of the catastrophe of the first week following the quake. A total of 1,995 persons were found dead under the rubble, including 268 children less than 16 years of age. There were 1,144 survivors. A total of 406 person were rescued alive from under the rubble of which an additional 37 persons died in a hospital following rescue. Most of the survivors have been relocated, but some remain in the area. There remains a need for psychological support for the survivors and rescuers.
Domestic Violence: Efficacy of Health Provider Training in Utah
Authors: Allert Charlene S. , Chalkley Christine , Whitney Jolene R. , Librett Allison
Published: July 2016

The purpose of this project was to improve the identification, treatment, and referral of domestic violence victims by prehospital care providers (Emergency Medical Technicians (EMTs) and paramedics) and emergency department personnel. The training focused on the definition of domestic violence, procedures to use when questioning patients about abuse, Utah's mandatory reporting law, and the referral of victims to community resources. While the training did improve the participant's knowledge concerning referral options and the law, health care providers still did not believe that domestic violence was a problem in their community. Although providers felt confident asking questions about abuse, the providers did not question patients unless they suspected domestic violence was the cause of the injury. Further training needs to be offered to staff to encourage regular screening for all adult patients.
Medical Relief Mission to Bosnia/Hercegovina: A Case Report
Authors: Tryon James R.
Published: July 2016

World attention has been focused on Bosnia/Hercegovina, where war erupted in 1992. The regional hospital of Mostar, an industrial city with a population of 100,000, operated -with chronic shortages of medical supplies including general anesthetic agents. In February 1992, just prior to the referendum for independence in that republic, a shipment of medical supplies with anesthesics, food, and clothing was delivered safely to Ljubuski, a village near Mostar, for Mostar hospital and surrounding clinics by a small, private organization from Birmingham, Alabama. No difficulties were encountered in delivering the supplies despite warnings from the U.S. State Department, the lengthy transit from Austria through Croatia to Bosnia, an active black market, and the inexperience of the relief agency. This disaster relief effort by a small, private sponsor was representative of both the positive aspects of such a project, as well as typical negative aspects. These efforts had been discouraged in the past, but as disaster medicine matures, there may be room for such endeavors, if properly directed.
Epidemiologic Assessment of Mortality, Building Collapse Pattern, and Medical Response after the 1992 Earthquake in Turkey
Authors: Angus Derek C. , Pretto Ernesto A. , Abrams Joel I. , Ceciliano Norma , Watoh Yukihiro , Kirimli Bülent , Certug Agah , Comfort Louise K. ,   Disaster Reanimatology Study Group (DRSG)
Published: July 2016

Background:

Post-earthquake engineering and epidemiologic assessments are important for the development of injury prevention strategies. This paper describes mortality and its relationship to building collapse patterns and initial medical responses following the 1992 earthquake in Erzincan, Turkey.

Methods:

The study consisted of: 1) background data collection and review; 2) design and implementation of a field survey; and 3) site inspection of building collapse patterns. The survey included: 1) national (n = 11) and local (n = 17) officials; 2) medical and search and rescue (SAR) workers (n = 38); and 3) a geographically stratified random sample of lay survivors (n = 105). The survey instruments were designed to gather information regarding location, injuries, initial actions and prior training of survivors and responders, and the location, injuries, and management of dead and dying victims. A case-control design was constructed to assess the relationship between mortality, location, and building collapse pattern.

Results:

There was extensive structural damage throughout the region, especially in the city where mid-rise, unreinforced masonry buildings (MUMBs) incorporating a “soft” first floor design (large store windows for commercial use) and one story adobe structures were most vulnerable to collapse. Of 526 people who died in the city, 87% (n = 456) were indoors at the time of the earthquake. Of these, 92% (n = 418) died in MUMBs. Of 54 witnessed deaths, 55% (n = 28) of victims died slowly, the majority of whom (n = 26) were pinned or trapped (p <0.05). Of 42 MUMB occupants identified through the survey, those who died (n = 25) were more likely to have been occupying the ground floor when compared with survivors (n = 28) (p <0.01). Official medical and search and rescue responders arrived after most deaths had occurred. Prior first-aid or rescue training of lay, uninjured survivors was associated with a higher likelihood of rescuing and resuscitating others (p <0.001).

Conclusion:

During an earthquake, MUMBs with soft ground floor construction are highly lethal, especially for occupants on the ground floor, suggesting that this building type is inappropriate for areas of seismic risk. The vulnerability of MUMBs appears due to a lack of lateral force resistance as a result of the use of glass store fiont windows and the absence of shear walls. The prevalence of this building type in earthquake-prone regions needs to be investigated further. A large portion of victims dying in an earthquake die slowly at the scene of injury. Prior public first-aid and rescue training programs increase participation in rescue efforts in major earthquakes and may improve survival.
Current Status of Clinical Education in Paramedic Programs: A Descriptive Research Project
Authors: Grubbs Kim C.
Published: July 2016

Development of competence in exercising therapeutic judgment skills represents the goal of clinical education. Time (clock hours) is not a valid predictor of attainment of competence in paramedic clinical education. Quantity of patient contact experiences facilitates development of judgment skills, and offers a valid measure of progress toward competence. This project uses national survey data from accredited programs to describe the availability and accessibility of patient contact experiences within paramedic clinical education. Data from this local program supplements the national survey results. The components of clinical judgment are enumerated, and strategies to teach and evaluate clinical judgment skills are discussed.
Reader Attitudes Toward Journal-Based Continuing Education for EMS Personnel
Authors: Moshinskie James F.
Published: July 2016

Abstract: Recertification requirements and new curricula place increased importance on continuing education (CE) for emergency medical services (EMS) personnel. To be effective, continuing education not only must be accessible to EMS personnel, but it must be also acceptable. Journal-based continuing education was selected to improve accessibility, but questions were raised about its acceptance. Although there were some significant differences found between the feelings of basic and advanced EMS personnel, a study conducted on six articles showed that participants overall liked this method. The study also found that some articles significantly generated more reader response than others.
The Impact of Standing Orders on Medication and Skill Selection, Paramedic Assessment, and Hospital Outcome: A Follow-up Report
Authors: Pointer James E. , Osur Michael , Campbell Colleen , Mathews Ben H. , McCall Chet
Published: July 2016

Introduction:

A prior report demonstrated a five-minute decrement in scene and total prehospital times in the standing order and limited standing order intervals as compared to control.

Methods:

The Alameda County Emergency Medical Service (EMS) District studied the impact of standing orders on field times, comparison of paramedic assessments with emergency department diagnoses, field drug use and procedures, and hospital outcome. These variables were studied over three discrete, six-week, time-study intervals, which represented three different levels of base-hospital medical control (control, standing order, and limited standing order).

Results:

There were no statistically significant differences between the three time-study intervals for the following variables: 1) incidence of prehospital administration of three cardiac arrest drugs; 2) incidence of prehospital administration of no drugs; 3) incidence of performance of endotracheal intubation; 4) incidence of performance of defibrillation; 5) assessment comparison; and 6) hospital outcome. There were statistically significant differences between intervals for incidence of: 1) administration of naloxone; 2) administration of 50% dextrose; 3) intravenous (IV) starts; and 4) paramedic performance of no procedures.

Conclusion:

Although there are several potential flaws in method, the data suggest that standing orders result in decreased incidence of drug administration and IV starts in non-critical situations without a negative impact on paramedic assessments or hospital outcome.
In-Field Comparison between Fully Automatic and Semi-Automatic Defibrillators
Authors: Bocka Joseph J. , Swor Robert
Published: July 2016

The purpose of this clinical study was to compare the prehospital use of fully automatic defibrillators versus semi-automatic defibrillators.

Methods:

Fully and semi-automatic defibrillator use by EMTs in neighboring communities was compared.

Results:

Both programs had similar response times, age and gender distribution, proportion of witnessed arrests, and proportion of patients found initially with ventricular fibrillation (VF). The time-to-shock from proper lead placement was shorter when the fully automatic defibrillator was used (16.6 vs. 44.3 seconds; p<.001) and the survival to hospital discharge rate was greater (26% vs. 0%; p=.O4). The semi-automatic defibrillators were more sensitive in detecting VF than were the fully automatic devices.

Conclusions:

These data support the need for further comparison of the efficacy and effectiveness of semi- and fully automatic, external defibrillators.
The Psycho-Social Needs of Health Professionals Providing On-Scene Disaster Care
Authors: Corneil D. Wayne
Published: July 2016

As evidenced in a number of recent disasters, there appears to be an increasing trend, for health care professionals to leave the confines of the hospital to provide on-scene care. This trend may be due to a number of recommendations from a variety of sources such as the National Disaster Medical System, the implementation of the United States Military Disaster Response, Federal Aviation Administration (FAA) recommended airport disaster plans, trends in community disaster planning, and Emergency Medical Services practice.
Evaluation of a New Cervical Immobilization/Extrication Device
Authors: Joyce Steven M. , Moser Chris S.
Published: July 2016

A new cervical immobilization device (the Philadelphia Red E.M. Collar with Head Immobilizer/Stabilizer), has been introduced as an adjunct in extricating potentially neck-injured patients. This study compared the efficacy of immobilization using the collar to that of the short spine board. In addition, experienced EMS personnel rated the collar in simulated field situations.

Methods:

In Part I of the study, the collar and a short spine board were applied to 25 adult volunteers in a sitting position, using standard methods. Each subject then exerted maximal force inflexion, extension, rotation, and abduction. Degrees of head motion from neutral position were measured in each direction. Mean values were compared using Student's t-test. For Part II, 10 EMS personnel were asked to apply the collar to volunteers. Each rated the performance of the collar on a scale of 1 (poor) to 4 (excellent) regarding: ease of application (sitting and supine), ease of extrication (lifting, logrolling, transfer), access to patient (chest auscultation, CPR, airway management), storage, and overall utility.

Results:

The collar was significantly better than the short spine board in both lateral and rotational immobilization (p<0.001). There was no significant difference for flexion or extension (p>0.05). The Red E.M. limited motion to a mean of 15° or less in any direction. Ratings by EMS personnel for the device (meant±standard error) were: ease of application (sitting) 3.5±0.2, (supine) 2.7±0.2; ease of extrication 3.1±0.2; access to patient 3.4±0.2; storage 3.1±0.3; and overall utility 3.1±0.2.

Conclusion:

This study indicates that the Philadelphia Red E.M. Collar with Head Immobilizer/Stabilizer is an effective and practical adjunct to stabilization and extrication of potentially neck-injured patients.
Developing EMS Quality Assessment Indicators
Authors: Dagher Michel , Lloyd Robert J.
Published: July 2016

An emergency medical service (EMS) system is part of a broad health care system which no longer can be concerned exclusively with patient transportation. Integration of prehospital and in-hospital emergency care must be achieved to provide quality patient care. This article suggests modifications in the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) 10-Step Model indicators that should help in an evaluation of the issues associated with the diversion of patients from Emergency Departments. The JCAHO model is one that can be used to help integrate prehospital and inhospital care.