bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AbstractIn 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

AbstractPrenatal 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

AbstractResearch 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

AbstractIntroduction: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

AbstractObjective: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

AbstractIn 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.
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.
The Cadre of Death Education Instructors in Paramedic Programs
Authors: Smith Tracy L. , Walz Bruce J. 
Published: July 2016

AbstractObjective: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

AbstractAn 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

AbstractThe 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

AbstractWorld 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

AbstractBackground: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

AbstractDevelopment 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.