bluuebunny/crossref_metadata_2025 huggingface dataset:
Child and adolescent health in northwestern Syria: Findings from Healthy-Syria 2017 study
Authors: Terkawi Abdullah Sulieman , Bakri Basil , Alsadek Amena S , Al-Hasan Abdulmuhsen H , Alrahhal Mohamad S , Alsaleh Farhan M , Alsatouf Fadia A , Arab Musaab I , Jnaid Hussam , Hadid Adnan A , Terkawi Rayan S , Zahran Manal M , Alghannam Nabiha A , Altirkawi Khalid A
Published: March 2019

Objectives: Since the uprising in 2011, there has been limited health-care data from inside Syria in the academic literature. This study aims to provide an updated account of pediatric health needs in the northwestern part of Syria; this should help inform the management and delivery of health-care services in this population.Methods: This is a prospective study, using a data registry, of all pediatric patients seen in a single center in northwestern Syria, between February and December 2017. We used international classification of diseases (ICD-10) codes to define cases, and tested several covariates, including age, sex, season of the year, and conditions of living for possible correlations with major illness categories.Results: We included 11,819 patients, of whom 5,288 (45%) were male and 6,531 (55%) were female. Collectively, these patients had 23,427 encounters. Respiratory diseases were the most encountered illnesses among all age groups (6320 [27%]), except late teen females, among whom gynecological/obstetric complaints dominated. Infectious diseases caused the greatest disease burden across all age groups, with upper respiratory tract infections (URTIs), infectious diarrhea, and otitis media representing almost half (47%) of all cases in this category. Nutritional deficiencies were diagnosed in 978 patients (8%), mostly in infants and toddlers (92%). We identified 1192 (17%) cases of acute diarrhea among all age groups, making it the second most common condition after URTIs. As compared to town residents, patients living in camps for internally displaced people accounted for more cases of infectious diarrhea (58%), chronic anemia (60%), and malnutrition (66%), especially severe acute malnutrition (76% of malnutrition cases). Vaccine-preventable illnesses represented a sizable category; we reported 69 cases of hepatitis A, 2 of poliomyelitis, 9 of pertussis, 37 of varicella, 11 of mumps, 8 of rubella, and 1 case of measles.Conclusion: We have identified urgent health-care issues in this population, including extreme malnutrition, high rates of infectious diseases, and high rates of teenage pregnancy. Also, we observed a relapse of some vaccine-preventable illnesses, such as mumps and rubella, which are likely associated with the decline in vaccination rates.
Frequency of mentum deformity in Chironomus sancticaroli (Diptera: Chironomidae) in a laboratory culture
Authors: Moura e Silva Mariana Silveira Guerra , Marigo Ana Lúcia Silva , Viveiros William , Kuhlmann Mônica Luisa
Published: March 2019

The midge Chironomus sancticaroli (Diptera: Chironomidae) has been used in ecotoxicological tests because it is sensitive to a variety of inorganic pollutants. Among the parameters used to evaluate the toxicity of a substance is the frequency of mentum deformity, which is part of the oral system of this organism. However, there is still no consensus on the baseline level (percentage) of acceptable deformities in laboratory cultures not exposed to pollutants. The determination of this variable is important to ensure the validity of bioassays and to compare cultures from different research and teaching institutions. Once this value is established, it will also be used to monitor the quality of organisms cultured, since factors such as inbreeding could increase the frequency of mentum deformity. Thus, the objective of this study was to quantify the percentage of mentum deformity in the fourth instar of C. sancticaroli larvae from the culture of the Laboratory of Aquatic Ecosystems, at Embrapa Meio Ambiente. The average frequency of mentum deformity obtained was 6,63%. It is believed that factors such as the renewal of the culture with the inclusion of spawns from the laboratories of other institutions, as well as the control of the quality of the dilution water and the sediment of the breeding may have contributed to a low frequency of mentum deformity of the culture observed in this study.
Prediction of Weather Impacts on Airport Arrival Meter Fix Capacity
Authors: Wang Yao
Published: March 2019

This paper introduces a data driven model for predicting airport arrival capacity with 2-8 hour look-ahead forecast data. The model is suitable for air traffic flow management by explicitly investigating the impact of convective weather on airport arrival meter fix throughput. Estimation of the arrival airport capacity under arrival meter fix flow constraints due to severe weather is an important part of Air Traffic Management (ATM). Airport arrival capacity can be reduced if one or more airport arrival meter fixes are partially or completely blocked by convective weather. When the predicted airport arrival demands exceed the predicted available airport’s arrival capacity for a sustained period, Ground Delay Program (GDP) operations will be triggered by ATM system. Severe imbalances between demand and capacity occur most frequently when the airport capacity is severely degraded due to either bad airport terminal surface weather or inclement convective weather around airport arrival fixes. A model that predicts the weather-impacted airport arrival meter fix throughput may help ATM personnel to plan GDP operations more efficiently. This paper identifies the characteristics of air traffic flow across arrival meter fixes at Newark Liberty International Airport (EWR). The proposed approach, based on machine-learning methods, is developed to predict the weather impacted EWR arrival Meter Fix (MF) throughput. Sector forecast coverage is used to envision the weather impact on airport arrival MF flow, and the validation is accomplished by using Convective Weather Avoidance Model (CWAM) 0.5 to 2-hour and Collaborative Convective Forecast Product (CCFP) 4 to 8-hour look-ahead forecast data for the period of April-September in 2014. Furthermore, the regression tree ensemble learning of random forests approach for translating a sector forecast coverage model to EWR arrival meter fix throughput is examined. The results suggest that ATM decision makers in charge of MF flow control and GDP planning may benefit from adopting the airport arrival meter capacity prediction models to estimate the inclement weather impacts.
Assembly 4.0 - Flexibly Picked Up, Precisely Mounted
Authors: Bock Matthias , Kleineberg Markus
Published: March 2019

Component deviations between as-designed and as-built as a result of deformations in the production process lead to significant cost increasing during assembly. After quality inspection, components are provisionally preassembled to determine their matching accuracy. Components with an acceptable tolerance range are then assembled. Otherwise costly reworks are required. Subsequently, the preassembly process is repeated until acceptable assembly tolerances are achieved. To avoid this time-consuming and costly process loop, a flexible mounting frame coupled with a real-time measuring system is used to optimize the assembly process. The flexible mounting frame can be applied for many applications where components are to be aligned and mounted. This flexible mounting frame allows the realization of exact shape and acceptable position tolerances.

The mounting frame consists of telescopic carbon fiber reinforced polymer (CFRP) tubes, linear actuators and suctions grippers. Linear actuators deform the component in the elastic range. Connected vacuum suction grippers hold the component securely to the mounting frame. The individually configurable joining device compensates manufacturing deviations during assembly in the elastic range. This is realized through a real time 3-D surface measuring system that assists in controlling a variable number of actuators. The geometric deviations are detected contactless by an external measuring system. This system provides the required measurements to control the actuators. By decoupling the measuring method from the manipulator, the system design can be kept very simple without compromising accuracy.

Furthermore, the frame is mounted on a mobile robot platform. The applied mobile robot platform consists of the mobile platform (KUKA omniMove) and an industrial robot (KR QUANTEC 150 R3300 prime K). By using such mobile robot, the system can be universally used. Moreover, components can be brought into the assembly position by contour optimized elastic deformation. This novel implementation of flexibly pick up and precisely mounting system results in a more efficient and faster assembly.
Collaborative Robotic Fastening Using Stereo Machine Vision
Authors: Haldimann Ryan
Published: March 2019

With typically over 2.3 million parts, attached with over 3 million fasteners, it may be surprising to learn that approximately two out of every three fasteners on a twin aisle aircraft are fastened by hand. In addition the fasteners are often installed in locations designed for strength and not necessarily ergonomics. These facts lead to vast opportunities to automate this tedious and repetitive task. The solution outlined in this paper utilizes the latest machine vision and robotics techniques to solve these unique challenges. Stereo machine vision techniques find the fastener on the interior of an aerospace structure and calculate the 6DOF (Degrees of Freedom) location in less than 500ms. Once the fastener is located, sealed, and inspected for bead width and gaps, a nut or collar is then installed. Force feedback capabilities of a collaborative robot are used to prevent part damage and ensure the nut or collar are properly located on the fastener. This type robot also opens up the possibility of interacting more closely with humans as fastening can be done simultaneously with other manual assembly processes. This paper outlines how automated fastening can be achieved using an end effector weighing less than 14kg by leveraging the capabilities of a collaborative robot and advanced machine vision techniques.
Automated Requirements and Traceability Generation for a Distributed Avionics Platform
Authors: Belschner Tim , Müller Peter , Reichel Reinhard
Published: March 2019

The development and qualification of distributed and highly safety-critical avionics systems implicate high efforts and risks. The resulting costs usually limit implementations like fly-by-wire systems to the military or commercial airliner domains. The aim of previous and ongoing research at the Institute of Aircraft Systems at University of Stuttgart is the reduction of these costs and therefore open up their benefits, inter alia, to general aviation, remotely piloted or unmanned aircraft. An approach for an efficient development is the application of a platform based development which supports the reuse of software and hardware components. The Flexible Platform adopts this approach. It is accompanied by a tool suite which automates the design and parameter instantiation, documentation generation and the generation of verification artifacts for a platform instance. This paper presents the approach for the requirement document generation compliant to ARP4754A and DO-178C. It is based on configurable requirement classes. In addition, relation classes build the base for the generation of a bidirectional traceability. The implemented system and high-level software requirement classes for the platform signal communication as well as their instantiation with the tool suite were validated with a representative platform instance model for a fly-by-wire system.
Global responsibility in mass casualty events: The Israeli experience in Japan
Authors: Merin, MD Ofer , Blumberg, MD Nehemia , Raveh, MD David , Bar, MD Ariel , Nishizawa, MD Masafumi , Cohen-Marom, MD Ophir
Published: March 2019

Objective: To describe humanitarian aid following the 2011 earthquake and tsunami in Japan.Setting: A field hospital deployed in a small Japanese coastal village devastated by a major tsunami.Patients: Thousands of Japanese refugees with minimal access to medical care.Results: After well-coordinated diplomatic efforts, our medical delegation was the first foreign team to deploy in Japan. Our facility served as a regional referral center for specialized medical treatment.Conclusions: Following major disasters, even highly modernized countries will face an urgent surge in the need of medical resources.These situations emphasize the need for global responsibility to provide assistance.
Opening students’ minds and hearts to the world without leaving home
Authors: Jones, EdD, CTRS David B.
Published: March 2019

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An investigation of the influence of vicarious experience on perceived self-efficacy
Authors: Harrison, PhD Mandy Marion Boyd , McGuire, PhD, CTRS Francis A.
Published: March 2019

Perceived self-efficacy is an indicator of maintenance, effort, and performance of various behaviors, including recreation therapy activities. The purpose of this study was to evaluate the effectiveness of one of the sources of efficacy information, vicarious experience via modeling, and to enhance efficacy beliefs of at-risk youth who are participating in a therapeutic adventure activity. Additionally, this study investigated the influence of activity specific efficacy perceptions on both self-regulatory self-efficacy (SRSE) and perceived performance in the specific activity. Results indicated that groups who observed a model demonstrate rock climbing during ground school had significantly higher rock climbing self-efficacy and SRSE after their rock climbing experience than the group that did not. In light of this research, it is apparent that providing a model is an effective tool that can be used to assist recreational therapists in offering effective programs.
Evidence supporting exercise interventions for persons in early-stage Alzheimer’s disease
Authors: Buettner, PhD, CTRS, LRT Linda , Richeson, PhD, CTRS Nancy E. , Yu, PhD Fang , Burgener, APRN-BC, FAAN, PhD Sandy C. , Buckwalter, PhD, RN, FAAN Kathleen Coen , Beattie, PhD Elizabeth , Bossen, MSN, RN Ann L. , Fick, PhD, APRN-BC Donna M. , Fitzsimmons, MS, APRN-BC Suzanne , Kolanowski, PhD, FAAN Ann , Rose, PhD, RN Karen , Pringle Specht, PhD, RN, FAAN Janet K. , Testad, PhD, RN Ingelin , McKenzie, PhD, CTRS Sharon
Published: March 2019

The purpose of this article is to grade research evidence supporting exercise-based interventions for persons with early-stage dementias and to report the recommendations of a consensus panel. The search produced 11 databased articles testing the effects of exercise interventions on a variety of outcomes. The body of evidence to support exercise interventions in the prevention and treatment of Alzheimer’s disease is growing and has potential as a treatment modality following translational studies in recreation therapy and other fields.
The use of groups as a therapeutic modality with individuals who are brain injured
Authors: Richard, MA, OT Lynne , Jakobov, MS, OTR Naama , Sosowsky, MS, OTR Beth B. , Leiser, MS, OTR Miryam
Published: March 2019

The use of groups as a treatment format with individuals with traumatic brain injury (TBI) was examined. A survey was constructed based on prior research, piloted, revised, and then sent to rehabilitation sites identified as Model Treatment Centers for individuals with TBI. The findings suggest that therapists (Recreational, OT, PT, and SLP) implement a variety of group types. Groups are used to address patient goals in the area of social and cognitive skills, self-awareness, and adjustment to disability and are generally used to complement individual therapy. Therapists cite work experience as preparation for leading groups and feel competent as group leaders. One third of the respondents prefer individual treatment and feel that there are barriers to implementing groups with this population. Implications for professional preparation and practice are discussed.
Determining the “other related duties” of therapeutic recreation and activity professionals: A pilot study
Authors: Witman, EdD, CTRS Jeffrey P. , Rakos, MEd, CTRS Kirk S.
Published: March 2019

Therapeutic Recreation (TR) professionals are increasingly being asked to perform "other related duties" beyond the traditional scope of their practice. This article presents a pilot study of TR practitioners in Pennsylvania designed to determine the nature of these other duties and respondents' perceptions of their impact. Findings suggest that professionals, on average, spend twenty percent of their work time on "other related duties." Specific duties include tasks in the areas of Activities of Daily Living (ADLs), agency-wide events, committee service, general duties, education/treatment, safety, and administrative duties. Respondents generally viewed these duties as making a positive impact on their job experience in a variety of contexts. The article concludes with implications for further research and for curriculum revision.
Benefits for caregivers: Case reports distinguishing potential benefits to caregivers of individuals with early stages of Alzheimer’s disease participating in designed community-based recreation programs
Authors: Lindenmeier, PhD Donna , Passmore, EdD, CTRS Tim , Tapps, MS Tyler , Gibson, EdD Hugh , Liang, PhD Yating
Published: March 2019

This is a presentation of three case reports of the potential benefits of community-based recreation programs for individuals caring for others diagnosed with early-stage Alzheimer’s disease.
The recovery movement: Proponents and opponents
Authors: Austin, PhD, FDRT, FALS David R.
Published: March 2019

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Efficacy of anger management interventions for individuals with traumatic brain injury: A systematic review
Authors: Seaton, LAT, ATC, MSRT Student McKenzie , DeFazio, CTRS Victoria , Porter, PhD, CTRS Heather R.
Published: March 2019

The purpose of this systematic review is to examine the efficacy of anger management interventions for individuals with traumatic brain injury (TBI). A total of 4,178 articles were identified of which six met the inclusion criteria. Anger management interventions included TBI education, anger education, emotional recognition, support, and maintenance of an anger log. Data were collected on eight outcomes (trait anger, anger expression-out, anger control, self-reported aggressiveness, anger recognition strategies, well-being, self-reported anger, and treatment satisfaction) with mixed findings. Suggestions for recreational therapy practice are provided. Further research is needed, particularly for the pediatric and adolescent TBI population.
Katrina and the necessity for emergency management standards
Authors: Bentley, Executive Director, EMAP Emily , Waugh, Jr., PhD, Editor-in-Chief William L.
Published: March 2019

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Manufactured housing and the 2004 hurricane season: Assessing the effectiveness of hazard mitigation
Authors: Grosskopf, PhD, CEM Kevin R.
Published: March 2019

The vast majority of some 22-million manufactured housing residents in the United States are ethnic, elderly, low-income populations. As the fourth most populous and second fastest growing US state, Florida is home to one of the nation’s largest concentrations of manufactured homes in one of its most geographically vulnerable regions. After-action reports from Hurricanes Charley, Jeanne, Frances, and Ivan indicate that all manufactured housing units constructed after the 1994 Federal Manufactured Housing Construction and Safety Standard survived intact, whereas units constructed before 1994 suffered damage ranging from severe to catastrophic. This paper provides manufactured housing damage-assessment data from 60 of 67 Florida counties affected by the 2004 hurricane season according to various federal and state hazard mitigation strategies implemented from 1976 to 1999.
September/October 2005
Authors: DeVito, Jr. Richard A.
Published: March 2019

Volume 3, Number 5
Rapidly assessing trauma exposure and stress resilience following large-scale disasters
Authors: Bracha, MD H. Stefan , Bienvenu, MD, PhD O. Joseph
Published: March 2019

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Curriculum-level goals in emergency-management education: Developing a common framework in an evolving field
Authors: O’Connor Jr., EdD Michael J.
Published: March 2019

Emergency management (EM) is a rapidly growing and evolving discipline. While only two degreelevel programs existed prior to 1995, they were joined by an additional 40 programs by 2005. These new programs contributed to a broad expansion of courses and instructional materials. However, none of this growth has been guided by a commonly agreed upon curricular framework. As a result, degree-level programs have varied widely in terms of what they consider an appropriate EM curriculum. The past several years have seen repeated efforts by a small group of academics and professionals to develop a standard curricular framework based on mutually agreed upon competencies, functions, and skills. This research project refines and builds upon these earlier efforts to create a unified list of broad curriculum-level goals. These goals were then qualitatively and quantitatively measured to identify specific themes that could be used to build an appropriate curriculum for EM bachelor’s and master’s degree-level programs.
Part 2: Social dimensions of interagency collaboration—team development
Authors: Simon, BS, MA Neil
Published: March 2019

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Disaster preparedness and response: Implications for public health nurses
Authors: Jennings-Sanders, Dr.PH, RN Andrea
Published: March 2019

Disasters are becoming more of an integral aspect of life in the United States and in other countries. Public health nurses are in the forefront of providing health services to people affected by disasters. Thus, it is essential that all public health nurses have access to information that will assist them in disaster situations. The purpose of this paper is to illustrate how the Framework for Public Health Nurses: Interventions Model can be utilized for planning and responding to disasters. The interventions in the model are directly applicable to disaster situations and, in addition, raise questions on issues that need to be addressed by local, state, and federal public health officials.
Crisis leadership versus leadership in crisis
Authors: Wilen, MD Saul B.
Published: March 2019

Effective leadership must already be in place when a crisis occurs. Leadership must be able to function during the crisis and effectively bring it to resolution so that recovery can begin and proceed as successfully as possible.The existing challenges reinforce the need for leadership that can operate on multiple planes. Competence, planning, and problem-solving abilities form the basis for determining a leader’s success. Innovation, decision making, a prevention orientation, risk taking, and risk management must all be part of the leadership skills package.
Disasters and the surge environment
Authors: Glotzer, DDS David L. , Psoter, DDS, PhD Walter J.
Published: March 2019

With the recent actual, and the anticipated possible, disastrous events in this country, it is an absolute duty of responsible agencies on all levels to prepare and improve the medical response system. Past experience has shown that one critical area of preparedness that needs to be addressed is the available number of trained individuals in the public health workforce that can and will respond. We propose that the dental profession, with proper additional training and integration into an organized healthcare system, can be one additional source of this much needed manpower.
The delivery of essential humanitarian services after the tsunami in Aceh, Indonesia
Authors: Doocy, PhD Shannon , Shankar, PhD Anita , Rassekh Bahie , Robinson, PhD Courtland , Burnham, MD, PhD Gilbert
Published: March 2019

A survey of 478 Indonesian households displaced by the tsunami was conducted in two districts in Aceh Province in late March and early April 2005. Essential services (shelter, water, food, health services) were provided to approximately half of internally displaced persons (IDPs) within seven days of the tsunami, and this figure rose to around 70 percent within two weeks of the tsunami. Essential services reached significantly greater proportions of the tsunami- displaced population in Aceh Besar than Banda Aceh at both two and four weeks post-tsunami. The majority of IDPs reported satisfaction with essential services other than shelter in the first two weeks posttsunami, and satisfaction with essential services other than food increased by four weeks after the tsunami. Of IDP households surveyed, the vast majority reported that there were services they would have liked to receive but did not, both in the month following the tsunami and at the time of the survey.
Training the nation’s responders for pandemic influenza: A Department of Homeland Security planning and preparedness initiative
Authors: Ryan, PhD Jeffrey R. , Kirchner, MD Allen W. , Glarum Jan G. , Davey Jennifer , Lavender, MSN, DSN Martha , George Dana , Abernathy Mandy , Knight Amie , Horn Heather , Castillo Mick , Cain III F. Marion
Published: March 2019

Communities all over the world are preparing for the next disaster. Lately, the World Health Organization has focused its attention on H5N1, a subtype of the influenza virus. H5N1, which most Americans recognize as “bird flu,” has caused massive losses in poultry production, as well as some human fatalities. Public officials have been warned that H5N1 may mutate into a strain that is not only highly pathogenic but also readily transmissible between humans. Should this occur, we might find ourselves on the verge of the next great pandemic. Because of this, community leaders, public health officials, and responders at planning and management levels face one of their most challenging problems: planning and preparing for pandemic influenza. Recently, an initiative at the Center for Domestic Preparedness was undertaken to assemble a training program for community leaders and senior responders that will address the current threat of a pandemic, outline an appropriate response to the problem, and exercise small planning teams using a tabletop model.
Making the transition from law enforcement to emergency management: Organizational, occupational, and cultural issues
Authors: Topp, MPA Walter S.
Published: March 2019

While the number of higher education programs in Emergency Management has increased significantly, many emergency management agencies continue to rely on emergency services organizations—including law enforcement agencies—as sources of experienced or trained emergency management practitioners. As the field of emergency management matures, however, becoming more complex, more technical, and significantly broader, law enforcement experience may no longer prepare an individual to succeed as a professional emergency manager. To ensure a successful transition, government officials seeking to fill emergency management leadership positions and law enforcement officers seeking to transition to emergency management must recognize the significant occupational, organizational, and cultural differences between law enforcement and emergency management, and they should develop strategies for mitigating those differences.
The evolution of response and management training at the FEMA Center for Domestic Preparedness
Authors: Stewart, MS Amanda , Marlow, MA Roy , Campeau, MS Denis , Russell, MA, MBA Tony , Ryan, PhD Jeffrey
Published: March 2019

The Federal Emergency Management Agency (FEMA) Center for Domestic Preparedness (CDP) was established in 1998 and is now 20 years old. In its short history, the CDP has significantly evolved the relevance and responsiveness of its courses and its capability to provide high-fidelity, hands-on training, and exercises to meet the demanding needs of today’s responders. This article discusses the basis of need for a competent, responder training program; the genesis of the CDP as a no-cost provider of responder training for state, local, tribal, and territorial responders; describes the current training opportunities available to responders; previews emerging training opportunities that are under development or envisioned in the very near future; and provides insight to the future progression of the CDP as it continues to expand and evolve its role as FEMA’s premiere, responder focused, hands-on training provider.
Framing higher education and disciplinary efforts through a professionalization lens
Authors: Cwiak, JD, PhD Carol L.
Published: March 2019

This article examines the characteristics of a profession, the role of the higher education community and emerging discipline in the emergency management professionalization process, and analysis of the FEMA Higher Education Program’s focus group efforts in support of the argument that successful professionalization efforts are necessarily dependent on emergency management higher education, an established emergency management academic discipline, and a robust body of knowledge.
Volume 17, Number 1
Authors: Emergency Management Journal of
Published: March 2019

Higher Education in Emergency Management: Pathways to Professional Excellence in a Demanding Career
Advancing emergency management higher education: Importance of cultural competence scholarship
Authors: Knox, PhD Claire Connolly , Emrich, PhD, GISP Christopher T. , Haupt, PhD Brittani
Published: March 2019

The evolving demographics, needs, and demands of society requires managers to be culturally competent in all phases of emergency management, especially when responding to disasters. A culturally incompetent manager and/or organization can increase a hazard's impact on often already vulnerable communities. Are cultural competencies lacking in emergency management education? Are these competencies as important as other highly regarded emergency management competencies? What are effective pedagogy and andragogy to create, implement, and evaluate cultural competency in emergency management higher education? As scholars work to advance the emergency management discipline, there is an increasing need for scholarship of teaching and learning research, especially regarding cultural competency. This article reviews the existing literature, as well as pedagogy from related disciplines, to identify gaps and provide recommendations for future research.
GIS applications in emergency management: Infusing geographic literacy in the classroom
Authors: Siebeneck, PhD Laura , Schumann III, PhD Ronald L. , Kuenanz, PhD Student Britt-Janet
Published: March 2019

Objective: The purpose of this article is to promote growth and recognition of geographic literacy among students, faculty, and emergency management practitioners through presentation of an array of possibilities that will further best practices in emergency management higher education.Design: Guided by previous research examining the development of geographic literacy in undergraduate students, this article provides examples of traditional and newer technologies in geographic information systems (GIS) and geospatial analysis that can be incorporated into the classroom to enhance the knowledge and skill sets of future emergency managers.Setting: The setting for this article includes colleges and universities offering emergency management degree programs.Results: The information resulting from a review of the literature provides a description of traditional and newer technologies used to address spatial issues in the management of hazards and disasters as well as practical suggestions for incorporating these technologies into classroom activities.Conclusions: Geographic literacy is an essential competency for the next generation of emergency managers and as such, classroom activities should provide students hands-on experience working with GIS and other geospatial technologies.
Knowledge and implementation of current opioid guidelines among healthcare providers in Manitoba
Authors: Sanchez-Ramirez, PhD, MPH, PT Diana C. , Polimeni, MD Christine
Published: March 2019

Objective: To explore self-perceived knowledge and implementation of current opioid guidelines among healthcare providers, and to assess the effect of an opioid-related educational intervention.Design: Pre-post.Setting: Academic.Participants: Sixty-nine participants completed the pre-intervention survey, 45 percent of them also completed a post-survey.Intervention: A short presentation on current opioid guidelines incorporated in a larger accredited continuing professional development (CPD) event.Outcomes: The 5-point Likert scale to express their level of agreement with seven statements was used to estimate their knowledge and implementation of current opioids guideline, along with their self-perceived abilities and level of comfort in prescribing opioids (Moore's conceptual framework).Results: Fifty percent of the participants were familiar with current opioid prescribing protocols and 46 percent were implementing them, 62 percent stated that were able to identify drug seeking behaviors in patients, 82 percent knew patients’ risk factors and 78 percent evaluated them before prescribing opioids, 90 percent indicated that they prescribed non-opioid alternatives, and 35 percent expressed that they feel comfortable prescribing opioids. Self-reported levels of familiarity with the current opioid prescribing protocols (p < 0.001) and knowledge of patients’ risk factors for prescribing opioids (p = 0.012) increased after the intervention. Improvements in their ability to identify drug seeking behavior in patients (p = 0.033), and in their comfort prescribing opioids for chronic non-cancer patients (p = 0.015) were also reported.Conclusions: Healthcare providers’ knowledge and implementation of current opioids guidelines need to be strengthened. A single presentation on the opioid crisis and guidelines incorporated within a larger CPD event showed significant gains in self-reported knowledge and skills among healthcare providers.
Implications of use of opioid-containing analgesics for palliation of acute dental pain
Authors: Chakote, DMD Karunesh , Guggenheimer, DDS James
Published: March 2019

Background: Initial palliation of acute dental pain with an opioid-containing pain reliever (OPR) is inappropriate but more likely to occur among the under- and uninsured who are unable to access the customary resources for dental care. Objective: To assess the implications of palliation with an OPR, the authors determined the prevalence of several health attributes and socioeconomic status (SES) of patients taking prescription or over-the-counter (OTC) palliative medications before they presented to an academically affiliated dental clinic for definitive treatment of acute dental pain.Methods: Prior palliation with any OPR/antibiotic combination was compared with a self-reported mood disorder, use of a psychotherapeutic or street drug, low SES (on Medicaid or self-payer), or high SES (having commercial dental insurance).Results: Palliative medications were being taken by 34 percent of 851 patients including 20 percent who were taking an OPR. Use of any palliative prescription medication was significantly associated with low SES (odds ratio: 1.25; 95%; confidence interval: 1.35-2.88; p = 0.004). By comparison, high SES patients were significantly more likely to have used OTC analgesics or no medication (p < 0.001). Significantly more low SES patients self-reported mood disorders and street drug use (p = 0.048 and p = 0.019), respectively. Patients taking OPRs included those with self-reported mood disorders or use of a psychotherapeutic or street drug.Conclusions: Palliation of acute dental pain with OPRs cannot resolve the underlying dental condition and contributes to drug misuse and adverse interactions. Preferable palliation should utilize combinations of non-OPR analgesics. These have fewer risks and may provide an incentive to seek definitive dental treatment.
Effect of different doses of remifentanil on stress response during laparoscopic cholecystectomy
Authors: Levantesi, MD Laura , Sessa, MD Flaminio , Congedo, MD Elisabetta , Di Nardo, MD Francesco , Oggiano, MD Marco , Canistro, MD Gennaro , Sicuranza, MD Rossella , Nicosia, MD Luca , De Cosmo, PhD Germano
Published: March 2019

Objectives: An adequate perioperative analgesia reduces neuroendocrine stress response and postoperative complications. Opioids are the most effective parenteral drugs to control pain and stress response.Design: This is a prospective randomized double-blinded controlled study.Setting: Institutional tertiary level.Patients, participants: Fifty patients underwent general anesthesia with desflurane for laparoscopic cholecystectomy.Main outcome measures: To compare two different doses of remifentanil (0.15 mcg/kg/min or 0.3 mcg/kg/min) in reducing markers of stress. Perioperative stress was assessed through the dosage of adrenocorticotropic hormone (ACTH), cortisol, growth hormone (GH), and prolactin (PRL). Three venous blood samples were collected from patients: before transferring the patient to the operating room (Time 0), at the trocar insertion (Time 1), and 1 hour after the end of the surgery (Time 2).Results: Hemodynamic parameters showed no differences between the two groups. The authors observed an increase of GH and PRL in both groups at trocar insertion (Time 1) (p = 0.473 and 0.754, respectively). ACTH and cortisol showed a decrease at Time 1 and an increase after surgery (p = 0.586). The modification of stress parameters levels showed no significant differences between the two groups.Conclusions: The results of our study showed that a lower dose of remifentanil is equally effective in controlling stress hormones during laparoscopic cholecystectomy.
The decrease in hippocampal transient receptor potential M2 (TRPM2) channel and muscarinic acetylcholine receptor 1 (CHRM1) is associated with memory loss in a surgical menopause rat model
Authors: Pala Sehmus , Atilgan Remzi , Kuloglu Tuncay , Yalçın Emre , Kaya Nalan , Etem Ebru
Published: March 2019

Introduction

The aim of the study was to investigate the association of transient receptor potential M2 (TRPM2) channel and muscarinic acetylcholine receptor 1 (CHRM1) activity with the memorial functions that are deteriorated in surgical menopause.

Material and methods

A total of 14 female rats were randomly divided into 2 groups: group (G)1: sham group; group (G)2: surgical menopause group, the group in which bilateral ovariectomy was performed. Fourteen days after the surgical procedure, learning and memorial tests were performed in G1 and G2 for a totally 13 days. The time required for the rats to find the cheese in the labyrinth was recorded and statistical evaluation of it was performed between groups. On the 14th day of the memory test, the rats were decapitated and the brain tissues were fixed in 10% formalin. Hippocampal TRPM2 and CHRM1 gene expression was evaluated with RNA isolation, complementary DNA (cDNA) synthesis and quantitative real-time PCR (qRT-PCR) analysis. TRPM2 and CHRM1 immunoreactivity was evaluated in hippocampal tissue with the immunohistochemical method. Histo-score was calculated regarding the diffuseness of and severity of the staining; and statistical analyses were performed.

Results

In the ovariectomized group, the mean time required for the rats to find the cheese was statistically significantly elongated (39.29 ±4.0 s vs. 29.86 ±2.6 s). When the hippocampal TRPM2 and CHRM1 gene expression and immunoreactivity were compared with the sham group, there was a statistically significant decrease in the surgical menopause group (p < 0.05).

Conclusions

In surgical menopause, in deterioration of memorial functions, hippocampal TRPM2 channel and CHRM1 activity plays an important role.
Aquatic and land aerobic training for patients with chronic low back pain: a randomized study
Authors: Kanitz Ana Carolina , Barroso Bruna Machado , Barbosa Guano Zambelli , Mello Andre Ivaniski , Bagatini Natalia Carvalho , Reichert Thais , Lucas Edmilson Pereira , Costa Rochelle Rocha , Delevatti Rodrigo Sudatti , Kruel Luiz Fernando Martins
Published: March 2019

Purpose

The study aimed to verify the influence of aerobic training environment on pain, disability, and oxygen uptake in patients with chronic low back pain.

Methods

The randomized study involved 14 patients of both sexes, with chronic low back pain. One group performed deepwater walking/running and the other practised land walking/running, both with moderate intensity. Pain, disability, peak oxygen uptake (VO2peak), and second ventilatory threshold oxygen uptake (VO2VT2) were assessed before and after the intervention.

Results

Decreases in pain and disability were observed in both groups, without differences between them. VO2peak and VO2VT2 did not change in either group after the training.

Conclusions

Aerobic exercise training of moderate intensity seems to be effective in improving pain symptoms and reducing disability among people with chronic low back pain, independently of the environment in which it is performed.
Characteristics of psychological resilience and body image in women in the early and late periods after mastectomy
Authors: Izydorczyk Bernadetta , Kwapniewska Anna , Lizińczyk Sebastian , Sitnik-Warchulska Katarzyna
Published: March 2019

Background

European statistics confirm a rise in breast cancer among women. Those suffering from breast cancer and undergoing mastectomy are undoubtedly experiencing a range of negative and/or positive emotions, thoughts and behaviours that depend on many factors such as psychological resilience. The study reported here aimed to identify factors that protect body image resilience in women suffering from breast cancer after mastectomy.

Participants and procedure

The research group comprised 120 women after either a short (up to 2 years) or a long (over 2 years) time since mastectomy. Three scales were applied, namely the Resilience Measurement Scale (SPP-25) developed by Juczyński and Ogińska-Bulik to measure the variability of psychological resilience, the Body Attitude Test (BAT) developed by Probst, and others (Polish version by Brytek-Matera), and Probst’s Body Self Questionnaire developed by Mirucka for the measurement of the body image.

Results

Post-mastectomy patients proved to have a significantly poorer self-assessment of the body, more restrictive eating behaviours and weight control employed with the aim to improve their appearance. Women just after mastectomy, seemed more focused on mobilising their resources necessary to adapt to new conditions and to restore balance after the difficult experience compared to women who had undergone mastectomy over 2 years before the study. The former are characterised by a higher degree of psychological resilience, higher perseverance and determination in action. They also better cope with experienced failure and negative emotions, which indicates that they have a greater capacity to detach from difficult situations.

Conclusions

The greater mobilisation of resources necessary to adapt to new conditions and to restore balance after a difficult experience require consideration and application of psychological support from the very beginning of treatment. For this reason, psychological counselling and work on strengthening resilience among women after mastectomy are indicated.
Adaptation and performance assessment of a quantum and interband cascade laser spectrometer for simultaneous airborne in situ observation of CH4, C2H6, CO2, CO and N2O
Authors: Kostinek Julian , Roiger Anke , Davis Kenneth J. , Sweeney Colm , DiGangi Joshua P. , Choi Yonghoon , Baier Bianca , Hase Frank , Groß Jochen , Eckl Maximilian , Klausner Theresa , Butz André
Published: March 2019

Abstract. Tunable laser direct absorption spectroscopy is a widely used technique for
the in situ sensing of atmospheric composition. Aircraft deployment poses a
challenging operating environment for instruments measuring
climatologically relevant gases in the Earth's atmosphere. Here, we
demonstrate the successful adaption of a commercially available continuous
wave quantum cascade laser (QCL) and interband cascade laser (ICL) based
spectrometer for airborne in situ trace gas measurements with a local to
regional focus. The instrument measures methane, ethane, carbon dioxide,
carbon monoxide, nitrous oxide and water vapor simultaneously, with high
1 s–1σ precision (740 ppt, 205 ppt, 460 ppb, 2.2 ppb, 137 ppt and 16 ppm,
respectively) and high frequency (2 Hz). We estimate a
total 1 s–1σ uncertainty of 1.85 ppb, 1.6 ppb, 1.0 ppm, 7.0 ppb
and 0.8 ppb in CH4, C2H6, CO2, CO and N2O, respectively.
The instrument enables simultaneous and continuous observations for all
targeted species. Frequent calibration allows for a measurement duty cycle
≥90 %. Custom retrieval software has been implemented and instrument
performance is reported for a first field deployment during NASA's
Atmospheric Carbon and Transport – America (ACT-America) campaign in fall 2017
over the eastern and central USA. This includes an inter-instrumental
comparison with a calibrated cavity ring-down greenhouse gas analyzer
(operated by NASA Langley Research Center, Hampton, USA) and periodic flask
samples analyzed at the National Oceanic and Atmospheric Administration
(NOAA). We demonstrate good agreement of the QCL- and ICL-based instrument to
these concurrent observations within the combined measurement uncertainty
after correcting for a constant bias. We find that precise knowledge of the
δ13C of the working standards and the sampled air is
needed to enhance CO2 compatibility when operating on the 2227.604 cm−1 13C16O2 absorption line.
The Mainz profile algorithm (MAPA)
Authors: Beirle Steffen , Dörner Steffen , Donner Sebastian , Remmers Julia , Wang Yang , Wagner Thomas
Published: March 2019

Abstract. The Mainz profile algorithm (MAPA) derives vertical profiles of
aerosol extinction and trace gas concentrations from MAX-DOAS measurements of
slant column densities under multiple elevation angles. This paper presents
(a) a detailed description of the MAPA (v0.98), (b) results for the CINDI-2
campaign, and (c) sensitivity studies on the impact of a priori assumptions
such as flag thresholds. Like previous profile retrieval schemes developed at MPIC, MAPA is based on a
profile parameterization combining box profiles, which also might be lifted,
and exponential profiles. But in contrast to previous inversion schemes based
on least-square fits, MAPA follows a Monte Carlo approach for deriving those
profile parameters yielding best match to the MAX-DOAS observations. This is
much faster and directly provides physically meaningful distributions of
profile parameters. In addition, MAPA includes an elaborated flagging scheme
for the identification of questionable or dubious results. The AODs derived with MAPA for the CINDI-2 campaign show good agreement with
AERONET if a scaling factor of 0.8 is applied for O4, and the
respective NO2 and HCHO surface mixing ratios match those derived
from coincident long-path DOAS measurements. MAPA results are robust with
respect to modifications of the a priori MAPA settings within plausible
limits.