bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of an Orthotropic Plate by Maclaurin's Series
Authors: Rajappa N. R. , Reddy D. V. 
Published: July 2016

A method is presented for the analysis of a simply-supported rectangular orthotropic plate subjected to a uniformly distributed load by the application of Maclaurin's series. The solutions have practical applications in the design of interconnected beam systems because of the elastic equivalence of the grid framework to an orthotropic plate.The application of Maclaurin's series to the analysis of beams in bending was first described by Hetényi. Recently Reddy and Gangadharan described a modified approach for beams with stepped variations in cross section. Ballesteros has extended the method to functions of two variables in the analysis of isotropic plates in bending.
Salmonellosis associated with mass catering: a survey of European Union cases over a 15-year period
Authors: OSIMANI A. , AQUILANTI L. , CLEMENTI F. 
Published: July 2016

SUMMARYSalmonellaspp. is the causative agent of a foodborne disease called salmonellosis, which is the second most commonly reported gastrointestinal infection in the European Union (EU). Although over the years the annual number of cases of foodborne salmonellosis within the EU has decreased markedly, in 2014, a total of 88 715 confirmed cases were still reported by 28 EU Member States. The European Food Safety Authority reported that, after the household environment, the most frequent settings for the transmission of infection were catering services. As evidenced by the reviewed literature, which was published over the last 15 years (2000–2014), the most frequently reported causative agents wereSalmonellaEnteritidis andSalmonellaTyphimurium serovars. These studies on outbreaks indicated the involvement of various facilities, including hospital restaurants, takeaways, ethnic restaurants, hotels, in-flight catering, one fast-food outlet and the restaurant of an amusement park. The most commonly reported sources of infection were eggs and/or egg-containing foods, followed by meat- and vegetable-based preparations. Epidemiological and microbiological studies allowed common risk factors to be identified, including the occurrence of cross-contamination between heat-treated foods and raw materials or improperly cleaned food-contact surfaces.
Romantic relationships and alcohol use: A long-term, developmental perspective
Authors: Rauer Amy J. , Pettit Gregory S. , Samek Diana R. , Lansford Jennifer E. , Dodge Kenneth A. , Bates John E. 
Published: July 2016

AbstractThis study considers the developmental origins of alcohol use in young adulthood. Despite substantial evidence linking committed romantic relationships to less problematic alcohol use in adulthood, the uniformity of these protective benefits across different romantic relationships is unclear. Further, the extent to which the establishment and maintenance of these romantic relationships is preceded by earlier adolescence alcohol use remains unknown. To address these gaps in the literature, the current study utilized multitiple-dimensional, multiple-informant data spanning 20 years on 585 individuals in the Child Development Project. Findings from both variable- and person-centered analyses support a progression of associations predicting adolescent alcohol use (ages 15–16), drinking, and romantic relationships in early adulthood (ages 18–25), and then problematic young adult alcohol use (age 27). Although adolescent alcohol use predicted greater romantic involvement and turnover in early adulthood, romantic involvement, but not turnover, appeared to reduce the likelihood of later problematic drinking. These findings remained robust even after accounting for a wide array of selection and socialization factors. Moreover, characteristics of the individuals (e.g., gender) and of their romantic relationships (e.g., partner substance use problems and romantic relationship satisfaction) did not moderate these findings. Findings underscore the importance of using a developmental–relational perspective to consider the antecedents and consequences of alcohol use early in the life span.
An Internet-based Exercise as a Component of an Overall Training Program Addressing Medical Aspects of Radiation Emergency Management
Authors: Levy Kirsten , Aghababian Richard V. , Hirsch Erwin F. , Screnci Domenic , Boshyan Anna , Ricks Robert C. , Samiei Massoud 
Published: July 2016

AbstractThe use of ionizing radiation and radioactive materials continues to increase worldwide in industry, medicine, agriculture, research, electrical power generation, and nuclear weaponry. The risk of terrorism using weapons of mass destruction or simple radiological devices also has increased, leading to heightened concerns. Radiation accidents occur as a consequence of errors in transportation ofradionuclides, use of radiation in medical diagnosis and therapy, industrial monitoring and sterilization procedures, and rarely, nuclear power generation. Compared to other industries, a small number of serious radiation accidents have occurred over the last six decades with recent cases in the Republic of Georgia, Peru, Japan, and Thailand. The medical, psychological, and political consequences of such accidents can be considerable. A number of programs designed to train medical responders in the techniques of radiation accident management have been developed and delivered in many countries. The low frequency of serious radiation accidents requires constant re-training, as skills are lost and medical staff turnover occurs. Not all of the training involves drills or exercises in which responders demonstrate learning or communication over the broad spectrum of medical response capabilities. Medical preparedness within the context of a total emergency response program is lacking in many parts of the world, particularly in Central and Eastern Europe and the Newly Independent States. This paper describes an effort to enhance medical preparedness in the context of a total program of international cooperation and conventions facilitated by the International Atomic Energy Agency. The paper concludes that novel application of telecommunications technology as part of a training activity in radiation accident preparedness can help address gaps in training in this field in which preparedness is essential but experience and practical field exercises are lacking.
Aseptic Efficacy of Prefilled Syringes in a Polluted Environment
Authors: Ninomiya Norifumi , Koido Yuichi , Yamamoto Yasuhiro 
Published: July 2016

AbstractIntroduction:To evaluate the aseptic efficacy of prefilled syringes compared with ampules when used in a polluted environment similar to that at a disaster site.Methods:The researchers tested epinephrine, 0.1%, atropine sulfate, 0.05%, and lidocaine hydrochloride solutions, 2% (Group A) as well as lidocaine hydrochloride, 10%, sodium bicarbonate, 8.4%, and glucose solutions, 50% (Group B), that frequently are used for intravenous injection and intravenous infusion respectively in Disaster Medicine.Each of these solutions in 10 prefilled syringes (PFSs) and 10 ampules was placed in a box of contaminated soil along with needles and empty syringes for ampules. In the box, each was taken out of its package, all syringes were connected with a needle, and empty syringes were filled with a solution. After this procedure, all syringes were taken out of the box to check their contents for bacterial contamination.Results:No bacterium was observed in any of the 10 Prefilled syringes samples of Group A and B solutions. In contrast, out of 10 ampule samples, six of the 10 samples containing epinephrine, nine of the 10 containing atropine sulfate, all 10 samples containing lidocaine hydrochloride, 2%, and all of the ampule samples containing Group B solutions tested positive for bacteria. A statistically significant difference was observed between the PFS and ampule samples in all six solutions.Conclusion:Results indicate that, in environments with airborne contaminants, the use of prefilled syringes may be useful for preventing bacterial contamination of the medicine inside.
Theme 5. Application of International Standards to Disasters: Summary and Action Plan
Authors: Burkle Frederick M. , Isaac-Renton Judy , Beck A. , Belgica Clifford P. , Blatherwick John , Brunet Lyse A. , Hardy Norman E. , Kendall Perry , Kunii Osamu , Lokey William , Sansom Guy , Stewart Ronald 
Published: July 2016

AbstractIntroduction:The need for the application of international standards has been evolving over the last decade. Consistency is needed not just in how we respond, but in when we respond. The discussions in this theme reflected on the progress of standard setting both at the local level and internationally.Methods:Details of the methods used are provided in the introductory paper. The chairs moderated all presentations and produced a summary that was presented to an assembly of all of the delegates. The chairs then presided over a workshop that resulted in the generation of a set of action plans that then were reported to the collective group of all delegates.Results:Main points developed during the presentations and discussion included: (1) requirement of standards of care for ALL disasters and core parameters, (2) process and procedure is best when there is interagency collaboration and coordination, (3) problems in disasters are management-related, not skill-related, and (4) standards of care must encompass evolving emergencies (e.g., emerging diseases, landmines).Discussion:The action plans for Theme 5 included: (1) develop positions of standards for management, health and public health, education and training, research, psychosocial aspects, and disaster plans; (2) advocate for actions and task forces to deal with evolving and emerging disasters, terrorism, landmines, and emerging infections; (3) proactively work to advocate and facilitate the multidisciplinary and multiorganizational requirements for disaster management; and (4) develop a resource list of interdisciplinary institutions and activities organized by country and topic including the design and maintenance of a website.Conclusions:There is a clear need for international standards for the management of disasters. Positions and advocacy for these positions are required to define and implement such standards.
Administrative Support of Emergency Medical Services Medical Directors: A Profile
Authors: Swor Robert A. , Krome Ronald L. 
Published: July 2016

AbstractPrehospital advanced life support (ALS) is provided by non-physicians under the supervision and the responsibility of a physician—the Emergency Medical Service Medical Director (EMSMD). In order to assess the time required of the EMSMD as well as the technical support provided and the medico-legal risks involved, a survey was distributed to physicians in attendance at the Annual Scientific Assemblies of the National Association of EMS Physicians in August 1986 and June 1987. The survey also was mailed to all EMSMDs in Michigan.Of the 66 EMS medical director respondents, 69% were compensated, 62% were provided with malpractice coverage, and 22% had been involved in legal actions. Clerical support was provided for 89%, office space for 58%, and 60% had access to a computerized record database system. The average time consumed per week was 17±13 hours.Differences were detected in the amount of support provided between services with an excess of 10,000 ALS responses per year and those with less than 10,000. The larger services more frequently provided office space and equipment (p<.02), malpractice coverage (p<.01), and access to a records database (p<.03) than did the smaller services. The EMSMDs for the larger services also were involved more frequently in legal actions (p<.03).Legal actions involved 14 of the EMSMDs: paramedic malpractice (6); system failures (3); dispatch errors (2); inappropriate receiving facility (2); and paramedic licensure, equipment failure, union grievance, withdrawal of medical control, and trauma center designation (1 each). Four of the 14 involved had not been provided with malpractice coverage.Medical direction of a prehospital EMS system requires a significant time commitment, incurs medico-legal risks, and in most communities receives clerical and data retrieval support, and the EMSMDs are compensated.
An Evaluation of Nitrous Oxide Analgesia During Transcutaneous Pacing
Authors: Kaplan Richard M. , Heller Michael B. , McPherson John , Paris Paul M. 
Published: July 2016

AbstractTranscutaneous cardiac pacing (TCP) is a promisingprehospital intervention, but there are little data available regarding protocols to improve patient tolerance to TCP. A 50:50 nitrous oxide:oxygen analgesic mixture aho is a commonly employed prehospital intervention. In this randomized, prospective study, we compared the discomfort experienced by 18 healthy subjects when paced in two triah at the capture threshold: one following breathing of a 50:50 nitrous oxide:oxygen mixture; and the second breathing only room air. Discomfort was rated on an analog scale from 1 (minimal discomfort) to 10 (severe pain). Of the 18 subjects, 15 (83%) reported that nitrous oxide improved the tolerance to pacing at capture threshold. The median pain scores at capture threshold in the nitrous oxide and room air group were 3.8 and 5.0 respectively (P<.05). Nine of the subjects tolerated TCP for the maximum allotted time of 30 seconds in each trial; six tolerated TCP for a longer time period in the nitrous oxide trial; three tolerated TCP longer in the room air trial. These data suggest that inhalation of a 50:50 nitrous oxide:oxygen mixture may improve tolerance to TCP in the conscious patient.
International Assistance Operations in Disaster Situations
Authors: Russbach Remi 
Published: July 2016

Sound disaster preparedness and a well-organized, local and material response will considerably reduce the necessity for calling on international assistance in the event of disaster. However, despite an excellent level of preparedness, some dramatic situations in the wake of a large-scale disaster always will make the mobilization of international resources absolutely essential.The international network for disaster relief is quite complex. Many governments have set up emergency relief teams to cope with disasters in their own countries and are able to assign these teams to international relief operations. This type of governmental assistance is provided under agreement with the other governments involved. The United Nations (UN), through the Office of the UN Disaster Relief Coordinator (UNDRO), can play a role in coordinating emergency operations.
The Role of Regional Anesthesia under Field Conditions
Authors: Klöss Thomas , Lenz Gunther , Schwandt-Boden Heidi , Bauer Johannes , Stehle Raimund 
Published: July 2016

AbstractThe authors, who served as anesthesiologists for 15 months at an International Committee of the Red Cross (ICRC) surgical field hospital in a Cambodian refugee camp, report their anesthesiologic experience with 2,906 patients. In spite of preferential use of regional anesthetic techniques, general anesthesia was required in 68% of the cases. Local infiltration anesthesia was applied in 21% of the cases, conduction anesthesia in 3%, and spinal anesthesia in 8%.
“Medical Miranda”—Improved Emergency Medical Dispatch Information From Police Officers
Authors: Clawson Jeff J. , Sinclair Bob 
Published: July 2016

AbstractIntroduction:Medical Miranda, also called Secondary Emergency Notification of Dispatch (Secondary Emergency Notification of Dispatch), is a low cost, effective, and welcome addition to emergency medical dispatching systems. The benefits are recognized by emergency medical dispatchers who receive feeder calls from associated public safety agencies that have trained both their field staff and call-takers in the Medical Miranda protocol.Hypothesis:The dispatchers would be more satisfied with feeder agencies that used the Secondary Emergency Notification of Dispatch protocol.Methods:A survey was conducted and analyzed, taking advantage of a situation in which two agencies (one used Secondary Emergency Notifi-cation of Dispatch) fed calls to the same communication center.Results:Dispatchers were more satisfied with the information gained from the feeder agency that used the Secondary Emergency Notification of Dispatch protocol and believed that the officers and dispatchers of that agency had afar better understanding of the emergency medical dispatcher's needs.Conclusions:When the emergency medical dispatcher does not talk directly with the reporting scene personnel or caller, Medical Miranda increases the usefulness of the information the dispatcher receives, helps the dispatcher better understand the reported medical emergency, and improves response appropriateness in emergency medical service (Emergency Medical Service) systems where responses routinely are prioritized.
The Cost-Benefit of Pulse-Oximeter Use in the Prehospital Environment
Authors: Macnab Andrew J. , Susak Lark , Gagnon Faith A. , Alred Janet , Sun Charles 
Published: July 2016

AbstractIntroduction:Pulse-oximetry has proven clinical value in Emergency Departments and Intensive Care Units. In the prehospital environment, oxygen is given routinely in many situations. It was hypothesized that the use of pulse oximeters in the prehospital setting would provide a measurable cost-benefit by reducing the amount of oxygen used.Methods:This was a prospective study conducted at 12 ambulance stations (average transport times >20 minutes). Standard care protocols and paramedic assessments were used to determine which patients received oxygen and the initial flow rate used. Pulse-oximetry measurements (oxygen-saturation measured by pulse oximetry) were then taken. If oxygen-saturation measured by pulse oximetry fell below 92% or rose above 96% (except in patients with chest pain), oxygen (O2) flow rates were adjusted. Costs of oxygen use were calculated: volume that would have been used based on initial flow rate; and volume actually used based on actual flow rates and transport time.Methods:A total of 1,907 patients were recruited. Oximetry and complete data were obtained on 1,787 (94%). Of these, 1,329 (74%) received O2 by standard protocol: 389 (27.5%) had the O2 flow decreased; 52 had it discontinued. Eighty-seven patients (6%) not requiring O2 standard protocol were hypoxemic (oxygen-saturation measured by pulse oximetry < 92%) by oximetry, and 71 patients (5%) receiving oxygen required flow rate increases. Overall, O2 consumption was reduced by 26% resulting in a cost-savings of $0.20 / patient. Prehospital pulse-oximetry allows unncessary or excessive oxygen therapy to be avoided in up to 55% of patients transported by ambulance and can help to identify suboptimally oxygenated patients (11%).Conclusion:Rationalizing the O2 administration using pulse-oximetry reduced O2 consumption. Other health care savings likely would result from a reduced incidence of suboptimal oxygenation. Oxygen cost-saving justifies oximeter purchase for each ambulance annually where patient volume exceeds 1,750, less frequently for lower call volumes, or in those services where the mean transport time is less than the 23 minute average noted in this study.
The Effect of Anti-Shock Garments on Prehospital Survival: The Need for Controlled Clinical Trials
Authors: Pepe Paul E. , Bickell William H. , Mattox Kenneth L. 
Published: July 2016

AbstractThere exists strong sentiment, among emergency medical personnel and physicians alike, that the pneumatic anti-shock garment (PASG) “saves lives.” As a result, controlled studies have been criticized as the “withholding of important therapy.” The purpose of this presentation is to confirm the need for controlled clinical trials of the PASG. Despite an early report that the PASG offered no advantage in terms of the presenting emergency center Trauma Score (TS), similar disparagements have continued, particularly because survival data were not discussed. The present report is a pilot analysis of the effect of the PASG on the prehospital survival of patients arriving at an urban trauma center in the United States. In the study, sixty-eight patients were assigned randomly to control and PASG groups in a prospective investigation involving injured patients with systemic hypotension. The 32 control patients, whose mean initial systolic blood pressure (BP) was 59 ± 32 mm Hg, and the 36 PASG-treated patients, whose mean initial BP was 55 ± 31 mm Hg, were found to be well matched for age, sex, type and location of injuries, initial field TS; response, field management, and transport times; and the total amount of intravenous crystalloid infused. The results demonstrated no significant difference between the control and PASG-treated groups in terms of those pronounced dead on arrival at the trauma center (9/32 vs. 10/36). Further studies are therefore justified to determine how the PASG affects the long-term morbidity and mortality of injury victims, particularly those within certain sub-groups such as penetrating abdominal versus those with penetrating thoracic injuries. This report reaffirms the need for early responsible, scientific scrutiny of prehospital interventions.
The Psychosocial Aftermath of the Chernobyl Disaster in an Area of Relatively Low Contamination
Authors: Koscheyev Victor S. , Leon Gloria R. , Gourine Andrej V. , Gourine Valerie N. 
Published: July 2016

AbstractIntroduction:There has been relatively little attention paid to the mid- and long-term effects of large-scale disasters, particularly their effects on children and young people. At the present time, the impact of the Chernobyl catastrophe on the daily lives of the affected population may include one of strong psychological stress due to uncertainty about ultimate health outcomes. Persons in the Chernobyl region in specific areas of low contamination may be affected similarly. This investigation assesses radiation concerns and attitudes about health and government information, nine years after the disaster, in a group of adults and adolescents residing in a relatively uncontaminated village in the Chernobyl area.Methods:Questionnaires were administered to 94 adults and 50 adolescents. Items assessed beliefs about extent of radiation exposure, health concerns regarding oneself and family members, past and current pre-occupation about the disaster, and trust in the accuracy of government information about health effects.Results:Considerable uncertainty was demonstrated in both adults and adolescents about the extent of their and their families exposure to radiation. Marked distrust of past and current government information about health effects was evident. A large proportion of subjects reported that they still thought frequently about the Chernobyl accident. They worried about health problems related to radiation exposure whenever they or their family members exhibited physical symptoms or complaints, and they urged family members to go to a medical clinic for evaluation to assess these symptoms.Conclusion:The extent of long-term concerns about the personal and family health effects of the Chernobyl disaster in this population residing in a relatively uncontaminated village is striking: the psychological impact on adolescents is considerable. The stress generated is maintained by the realistic uncertainty about the ultimate health consequences to the overall population as a result of radiation exposure and distrust in government information about contamination levels in this particular village. The level of stress and its effects on physical and mental health may increase over time if there is a rise in morbidity in the area. The continuing health needs of the extremely large population affected by the Chernobyl disaster need to be addressed.