2016-08-29T19-54-55Z
Source: International Journal of Therapies and Rehabilitation Research
Mohamed Rizk Abd El Wahab.
Objective: To assess the therapeutic efficacy Inspiratory muscle trainer on pulmonary function capacity in patients with inhalation injury patients. Material and Methods: Forty male patients suffering from inhalation injury were been included in this study, their ages ranged from 20 - 40 years old. These patients were randomly subdivided into two equal groups (twenty patients for each Group (A) = (Exercise Group) This group was composed of 20 patients suffering from inhalation injury, and were represented the group who were received inspiratory muscle training in addition to routine chest physiotherapy in form of (deep breathing, coughing and early ambulation) three times per week for four weeks. Group (B) = (Control Group): This group was composed of 20 patients suffering from inhalation injury, and were represent the control group who were not received inspiratory muscle training but this group were received routine chest physiotherapy alone.. Results: According to unpaired t-test and when comparing the two groups (A and B) before treatment, the X' ± SD values were 2.26 ± 0.48 and 2.41 ± 0.58 respectively which indicated no significant improvement (p= 0.000), while comparing the two groups after four weeks of treatment, the X' ± SD values were 3.5 ± 0.46 and 3.07 ± 0.56 respectively which indicated a significant improvement (p= 0.005) in favor of group A (MD= 0.43) and % of improvement was 12.28 %. . Conclusion: it was concluded that inspiratpry muscle trainer had positive and significant effect on pulmonary function capacity in patient with inhalation injury.
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Δευτέρα 29 Αυγούστου 2016
EFFECT OF INSPIRATORY MUSCLE TRAINER ON PULMONARY FUNCTION CAPACITY IN PATIENTS WITH INHALATION INJURY
The Authors Respond
Publication date: September 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 9
Author(s): Flavie Frémondière, Franck Lacoeuille, Avigaëlle Sher, Olivier Couturier, Philippe Menei, Isabelle Richard, Mickaël Dinomais
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Editorial Board
Publication date: September 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 9
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Table of Contents
Publication date: September 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 9
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Editors' Selections From This Issue: Volume 97 / Number 9 / September 2016
Publication date: September 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 9
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Measurement Characteristics and Clinical Utility of the Spinal Cord Independence Measure-III Among Individuals With Spinal Cord Injury
Publication date: September 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 9
Author(s): Kristian P. Nitsch, Kelsey L. Stipp
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Faces of an emergency
EMS artwork by Daniel Sundahl. Check out more of his work here.
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Louisiana floods: How a USAR task force responded to social media inquiries
By Catherine R. Counts and Ruel Douvillier
During the week in mid-August that saw seven trillion gallons of rain fall on southern Louisiana, the Louisiana Task Force 1 Urban Search and Rescue Team (LATF-1) received over half a dozen requests for aid or information via Facebook Messenger.
Given that more than 20,000 people were rescued from rising flood waters over the course of that same week, half a dozen requests may seem like a drop of rain in the ocean, but to those individuals, LATF-1 was a governmental entity that could help, and in many cases, it was the only one responding via social media.
Calls for help or information
We were activated on August 13th and deployed on August 14th for water-based search and rescue missions, joining the hundreds, if not thousands, of other boats filling Louisiana's flooded roadways to make sure our neighbors were not trapped by the rising waters. That mission evolved into a search and recovery mission as the week progressed.
After the first message was received LATF-1 leadership made the decision to respond to all messages as they were received. Since we only ever received second hand information from worried families and friends we had no way of knowing the accuracy or reliability of the information we were passing on. We passed each call for assistance on anyway, directly to the Operations Section Chief of the Incident Management Team.
We thanked the messenger with a text response and let them know we had forwarded the request to the "appropriate authorities." In all cases we received a reply message of thanks, and sometimes even an update once the flood victims had been rescued.
Although the Facebook Safety Check was activated during the flooding, given the large geographic area, varying timelines of the flooding and a lack of data coverage in the effected areas, it was a less than reliable source for accurate information on an individual's safety.
In some cases, we had no way of knowing whether or not we played any part in the rescue of these individuals, while in others we were informed of the victim's rescue before the Incident Management Team could even deploy a response team. But we do know that we played a role in the trust that the citizens of Louisiana place in governmental agencies. In that moment, they felt their voice had been heard.
Armchair responders
Given past false alarms we try to intentionally delay alerting social media about our deployments until they are already underway. However, in this case, a real deployment happened and we didn't tell our followers until four days in to the response phase.
Once we posted something, most Facebook page fans simply liked or shared the post, with a select few sending comments of prayer and well wishes.
To our surprise, we did receive one comment to the effect of "what took you so long?" This comment likely mirrored the growing frustration with the lack of national media coverage surrounding the flooding.
Rather than delete the comment or block the commenter we choose to respond as diplomatically as possible. Simply stating that we had been deployed since the weekend prior and had been unable to post an update.
The comment was almost instantly deleted by its author.
When being diplomatic doesn't work
As a search and rescue team we are first and foremost responsible for the care of people. Although we have a canine team, many of whom were also deployed, we only assist with an animal rescue should we encounter one in the course of regular operations. We are not trained, nor expected, to seek out rescues geared towards pets, livestock, or other four-legged living beings.
But not everyone knows that.
Once the waters started to recede, two individuals reached out, both attempting to rescue the same group of neglected dogs. Although the dogs weren't in a flooded area, it was obvious they needed help, and these women had taken the initiative — independent of one another — to provide food and water while seeking out an organization that could formally take on the animals.
That's when they found us. And for the next two days we messaged back and forth, explaining that we worked within a structured response system and couldn't "break ranks" to rescue these dogs. At times their frustration with our inability to assist was so apparent they asked for the name of the Operations Section Chief, something we weren't able to provide.
It took a phone call from one of our canine handlers explaining our model of response as well as recommending a number of animal groups conducting rescues in the area to reach a mutual understanding that we weren't the appropriate group. The concerned individuals thanked us for the information and never contacted us again.
A week later we determined that the dogs had been rescued by the original messenger and personally transported to a nearby no-kill shelter. No official rescue groups, animal or human, had been involved in their care.
Lessons learned
Our USAR task force is extremely lucky to have an overwhelmingly supportive group of social media followers. Not only do they include our first responders and their family members, but also strangers from every corner of the globe. That level of support was mirrored during this recent activation from most, if not every, follower.
However, given the similarities that this disaster shared with Hurricane Katrina, both in scope and size, as well as a lack of national media attention and a polarized political response, many of the negative emotions we were facing weren't necessarily directed at us.
But that doesn't mean we shouldn't have been prepared to respond. Because the last thing we want to do is discourage any requests for help.
We now know that managing our Facebook page during this activation would have been significantly less stressful had we incorporated the following:
- Designate one person to handle all social media responses and postings.
- Ensure that no personal contact information is available on the public page.
- Pre-identify contact information that the public can use to request aid.
- Alert our followers to an activation within 24 hours.
- Have an automatic response to Facebook messages.
- Pre-script responses for requests for aid, with the next steps delineated depending on the type of request received.
- Develop a mechanism for determining the timeliness of a second-hand request for aid to avoid any false alarms.
As demonstrated by the thousands of private citizens, better as known as the Cajun Navy, that deployed their boats into the flood waters looking to help with rescues, the people of Louisiana are more than willing to step into action when they feel that the government isn't doing enough. But a lack of responsiveness on social media should never be deemed as the reason why they feel the need to launch out on their own.
We are proud to have been active on social media during the recent flooding and we will continue to improve our utilization of this modern day communication platform to reflect our recent experiences. We owe it to those individuals we have sworn to serve.
About the authors:
Ruel Douvillier spent 20 years in the Army, serving as a medic, infantryman and paratrooper. He spent five years as a paramedic with New Orleans Emergency Medical Services, and 14 years with the New Orleans Fire Department, most of that time with their heavy technical rescue squads. He has also served with private ambulance services and volunteer and combination fire departments. He has extensive experience as an instructor. Ruel is presently the Task Force Leader of the State and Regional USAR team, Louisiana Task Force 1 and the Operations Manager for SAR Specialists, an emergency response training company.
Catherine R. Counts is a doctoral candidate in the department of Global Health Management and Policy at Tulane University School of Public Health and Tropical Medicine where she also previously earned her Master of Health Administration. Counts has research interests in domestic health care policy, quality and patient safety, organizational culture and prehospital emergency medicine. She is a member of AcademyHealth, Academy of Management, the National Association of EMS Physicians, and National Association of EMTs. In her spare time, Counts serves as one of the Canine Managers of the State and Regional USAR team, Louisiana Task Force 1.
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Louisiana floods: How a USAR task force responded to social media inquiries
By Catherine R. Counts and Ruel Douvillier
During the week in mid-August that saw seven trillion gallons of rain fall on southern Louisiana, the Louisiana Task Force 1 Urban Search and Rescue Team (LATF-1) received over half a dozen requests for aid or information via Facebook Messenger.
Given that more than 20,000 people were rescued from rising flood waters over the course of that same week, half a dozen requests may seem like a drop of rain in the ocean, but to those individuals, LATF-1 was a governmental entity that could help, and in many cases, it was the only one responding via social media.
Calls for help or information
We were activated on August 13th and deployed on August 14th for water-based search and rescue missions, joining the hundreds, if not thousands, of other boats filling Louisiana's flooded roadways to make sure our neighbors were not trapped by the rising waters. That mission evolved into a search and recovery mission as the week progressed.
After the first message was received LATF-1 leadership made the decision to respond to all messages as they were received. Since we only ever received second hand information from worried families and friends we had no way of knowing the accuracy or reliability of the information we were passing on. We passed each call for assistance on anyway, directly to the Operations Section Chief of the Incident Management Team.
We thanked the messenger with a text response and let them know we had forwarded the request to the "appropriate authorities." In all cases we received a reply message of thanks, and sometimes even an update once the flood victims had been rescued.
Although the Facebook Safety Check was activated during the flooding, given the large geographic area, varying timelines of the flooding and a lack of data coverage in the effected areas, it was a less than reliable source for accurate information on an individual's safety.
In some cases, we had no way of knowing whether or not we played any part in the rescue of these individuals, while in others we were informed of the victim's rescue before the Incident Management Team could even deploy a response team. But we do know that we played a role in the trust that the citizens of Louisiana place in governmental agencies. In that moment, they felt their voice had been heard.
Armchair responders
Given past false alarms we try to intentionally delay alerting social media about our deployments until they are already underway. However, in this case, a real deployment happened and we didn't tell our followers until four days in to the response phase.
Once we posted something, most Facebook page fans simply liked or shared the post, with a select few sending comments of prayer and well wishes.
To our surprise, we did receive one comment to the effect of "what took you so long"" This comment likely mirrored the growing frustration with the lack of national media coverage surrounding the flooding.
Rather than delete the comment or block the commenter we choose to respond as diplomatically as possible. Simply stating that we had been deployed since the weekend prior and had been unable to post an update.
The comment was almost instantly deleted by its author.
When being diplomatic doesn't work
As a search and rescue team we are first and foremost responsible for the care of people. Although we have a canine team, many of whom were also deployed, we only assist with an animal rescue should we encounter one in the course of regular operations. We are not trained, nor expected, to seek out rescues geared towards pets, livestock, or other four-legged living beings.
But not everyone knows that.
Once the waters started to recede, two individuals reached out, both attempting to rescue the same group of neglected dogs. Although the dogs weren't in a flooded area, it was obvious they needed help, and these women had taken the initiative — independent of one another — to provide food and water while seeking out an organization that could formally take on the animals.
That's when they found us. And for the next two days we messaged back and forth, explaining that we worked within a structured response system and couldn't "break ranks" to rescue these dogs. At times their frustration with our inability to assist was so apparent they asked for the name of the Operations Section Chief, something we weren't able to provide.
It took a phone call from one of our canine handlers explaining our model of response as well as recommending a number of animal groups conducting rescues in the area to reach a mutual understanding that we weren't the appropriate group. The concerned individuals thanked us for the information and never contacted us again.
A week later we determined that the dogs had been rescued by the original messenger and personally transported to a nearby no-kill shelter. No official rescue groups, animal or human, had been involved in their care.
Lessons learned
Our USAR task force is extremely lucky to have an overwhelmingly supportive group of social media followers. Not only do they include our first responders and their family members, but also strangers from every corner of the globe. That level of support was mirrored during this recent activation from most, if not every, follower.
However, given the similarities that this disaster shared with Hurricane Katrina, both in scope and size, as well as a lack of national media attention and a polarized political response, many of the negative emotions we were facing weren't necessarily directed at us.
But that doesn't mean we shouldn't have been prepared to respond. Because the last thing we want to do is discourage any requests for help.
We now know that managing our Facebook page during this activation would have been significantly less stressful had we incorporated the following:
- Designate one person to handle all social media responses and postings.
- Ensure that no personal contact information is available on the public page.
- Pre-identify contact information that the public can use to request aid.
- Alert our followers to an activation within 24 hours.
- Have an automatic response to Facebook messages.
- Pre-script responses for requests for aid, with the next steps delineated depending on the type of request received.
- Develop a mechanism for determining the timeliness of a second-hand request for aid to avoid any false alarms.
As demonstrated by the thousands of private citizens, better as known as the Cajun Navy, that deployed their boats into the flood waters looking to help with rescues, the people of Louisiana are more than willing to step into action when they feel that the government isn't doing enough. But a lack of responsiveness on social media should never be deemed as the reason why they feel the need to launch out on their own.
We are proud to have been active on social media during the recent flooding and we will continue to improve our utilization of this modern day communication platform to reflect our recent experiences. We owe it to those individuals we have sworn to serve.
About the authors:
Ruel Douvillier spent 20 years in the Army, serving as a medic, infantryman and paratrooper. He spent five years as a paramedic with New Orleans Emergency Medical Services, and 14 years with the New Orleans Fire Department, most of that time with their heavy technical rescue squads. He has also served with private ambulance services and volunteer and combination fire departments. He has extensive experience as an instructor. Ruel is presently the Task Force Leader of the State and Regional USAR team, Louisiana Task Force 1 and the Operations Manager for SAR Specialists, an emergency response training company.
Catherine R. Counts is a doctoral candidate in the department of Global Health Management and Policy at Tulane University School of Public Health and Tropical Medicine where she also previously earned her Master of Health Administration. Counts has research interests in domestic health care policy, quality and patient safety, organizational culture and prehospital emergency medicine. She is a member of AcademyHealth, Academy of Management, the National Association of EMS Physicians, and National Association of EMTs. In her spare time, Counts serves as one of the Canine Managers of the State and Regional USAR team, Louisiana Task Force 1.
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Louisiana floods: How a USAR task force responded to social media inquires
By Catherine R. Counts and Ruel Douvillier
During the week in mid-August that saw seven trillion gallons of rain fall on southern Louisiana, the Louisiana Task Force 1 Urban Search and Rescue Team (LATF-1) received over half a dozen requests for aid or information via Facebook Messenger.
Given that more than 20,000 people were rescued from rising flood waters over the course of that same week, half a dozen requests may seem like a drop of rain in the ocean, but to those individuals, LATF-1 was a governmental entity that could help, and in many cases, it was the only one responding via social media.
Calls for help or information
We were activated on August 13th and deployed on August 14th for water-based search and rescue missions, joining the hundreds, if not thousands, of other boats filling Louisiana's flooded roadways to make sure our neighbors were not trapped by the rising waters. That mission evolved into a search and recovery mission as the week progressed.
After the first message was received LATF-1 leadership made the decision to respond to all messages as they were received. Since we only ever received second hand information from worried families and friends we had no way of knowing the accuracy or reliability of the information we were passing on. We passed each call for assistance on anyway, directly to the Operations Section Chief of the Incident Management Team.
We thanked the messenger with a text response and let them know we had forwarded the request to the "appropriate authorities." In all cases we received a reply message of thanks, and sometimes even an update once the flood victims had been rescued.
Although the Facebook Safety Check was activated during the flooding, given the large geographic area, varying timelines of the flooding and a lack of data coverage in the effected areas, it was a less than reliable source for accurate information on an individual's safety.
In some cases, we had no way of knowing whether or not we played any part in the rescue of these individuals, while in others we were informed of the victim's rescue before the Incident Management Team could even deploy a response team. But we do know that we played a role in the trust that the citizens of Louisiana place in governmental agencies. In that moment, they felt their voice had been heard.
Armchair responders
Given past false alarms we try to intentionally delay alerting social media about our deployments until they are already underway. However, in this case, a real deployment happened and we didn't tell our followers until four days in to the response phase.
Once we posted something, most Facebook page fans simply liked or shared the post, with a select few sending comments of prayer and well wishes.
To our surprise, we did receive one comment to the effect of "what took you so long?" This comment likely mirrored the growing frustration with the lack of national media coverage surrounding the flooding.
Rather than delete the comment or block the commenter we choose to respond as diplomatically as possible. Simply stating that we had been deployed since the weekend prior and had been unable to post an update.
The comment was almost instantly deleted by its author.
When being diplomatic doesn't work
As a search and rescue team we are first and foremost responsible for the care of people. Although we have a canine team, many of whom were also deployed, we only assist with an animal rescue should we encounter one in the course of regular operations. We are not trained, nor expected, to seek out rescues geared towards pets, livestock, or other four-legged living beings.
But not everyone knows that.
Once the waters started to recede, two individuals reached out, both attempting to rescue the same group of neglected dogs. Although the dogs weren't in a flooded area, it was obvious they needed help, and these women had taken the initiative — independent of one another — to provide food and water while seeking out an organization that could formally take on the animals.
That's when they found us. And for the next two days we messaged back and forth, explaining that we worked within a structured response system and couldn't "break ranks" to rescue these dogs. At times their frustration with our inability to assist was so apparent they asked for the name of the Operations Section Chief, something we weren't able to provide.
It took a phone call from one of our canine handlers explaining our model of response as well as recommending a number of animal groups conducting rescues in the area to reach a mutual understanding that we weren't the appropriate group. The concerned individuals thanked us for the information and never contacted us again.
A week later we determined that the dogs had been rescued by the original messenger and personally transported to a nearby no-kill shelter. No official rescue groups, animal or human, had been involved in their care.
Lessons learned
Our USAR task force is extremely lucky to have an overwhelmingly supportive group of social media followers. Not only do they include our first responders and their family members, but also strangers from every corner of the globe. That level of support was mirrored during this recent activation from most, if not every, follower.
However, given the similarities that this disaster shared with Hurricane Katrina, both in scope and size, as well as a lack of national media attention and a polarized political response, many of the negative emotions we were facing weren't necessarily directed at us.
But that doesn't mean we shouldn't have been prepared to respond. Because the last thing we want to do is discourage any requests for help.
We now know that managing our Facebook page during this activation would have been significantly less stressful had we incorporated the following:
- Designate one person to handle all social media responses and postings.
- Ensure that no personal contact information is available on the public page.
- Pre-identify contact information that the public can use to request aid.
- Alert our followers to an activation within 24 hours.
- Have an automatic response to Facebook messages.
- Pre-script responses for requests for aid, with the next steps delineated depending on the type of request received.
- Develop a mechanism for determining the timeliness of a second-hand request for aid to avoid any false alarms.
As demonstrated by the thousands of private citizens, better as known as the Cajun Navy, that deployed their boats into the flood waters looking to help with rescues, the people of Louisiana are more than willing to step into action when they feel that the government isn't doing enough. But a lack of responsiveness on social media should never be deemed as the reason why they feel the need to launch out on their own.
We are proud to have been active on social media during the recent flooding and we will continue to improve our utilization of this modern day communication platform to reflect our recent experiences. We owe it to those individuals we have sworn to serve.
About the authors:
Ruel Douvillier spent 20 years in the Army, serving as a medic, infantryman and paratrooper. He spent five years as a paramedic with New Orleans Emergency Medical Services, and 14 years with the New Orleans Fire Department, most of that time with their heavy technical rescue squads. He has also served with private ambulance services and volunteer and combination fire departments. He has extensive experience as an instructor. Ruel is presently the Task Force Leader of the State and Regional USAR team, Louisiana Task Force 1 and the Operations Manager for SAR Specialists, an emergency response training company.
Catherine R. Counts is a doctoral candidate in the department of Global Health Management and Policy at Tulane University School of Public Health and Tropical Medicine where she also previously earned her Master of Health Administration. Counts has research interests in domestic health care policy, quality and patient safety, organizational culture and prehospital emergency medicine. She is a member of AcademyHealth, Academy of Management, the National Association of EMS Physicians, and National Association of EMTs. In her spare time, Counts serves as one of the Canine Managers of the State and Regional USAR team, Louisiana Task Force 1.
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via IFTTT
Louisiana floods: How a USAR task force responded to social media inquires
By Catherine R. Counts and Ruel Douvillier
During the week in mid-August that saw seven trillion gallons of rain fall on southern Louisiana, the Louisiana Task Force 1 Urban Search and Rescue Team (LATF-1) received over half a dozen requests for aid or information via Facebook Messenger.
Given that more than 20,000 people were rescued from rising flood waters over the course of that same week, half a dozen requests may seem like a drop of rain in the ocean, but to those individuals, LATF-1 was a governmental entity that could help, and in many cases, it was the only one responding via social media.
Calls for help or information
We were activated on August 13th and deployed on August 14th for water-based search and rescue missions, joining the hundreds, if not thousands, of other boats filling Louisiana's flooded roadways to make sure our neighbors were not trapped by the rising waters. That mission evolved into a search and recovery mission as the week progressed.
After the first message was received LATF-1 leadership made the decision to respond to all messages as they were received. Since we only ever received second hand information from worried families and friends we had no way of knowing the accuracy or reliability of the information we were passing on. We passed each call for assistance on anyway, directly to the Operations Section Chief of the Incident Management Team.
We thanked the messenger with a text response and let them know we had forwarded the request to the "appropriate authorities." In all cases we received a reply message of thanks, and sometimes even an update once the flood victims had been rescued.
Although the Facebook Safety Check was activated during the flooding, given the large geographic area, varying timelines of the flooding and a lack of data coverage in the effected areas, it was a less than reliable source for accurate information on an individual's safety.
In some cases, we had no way of knowing whether or not we played any part in the rescue of these individuals, while in others we were informed of the victim's rescue before the Incident Management Team could even deploy a response team. But we do know that we played a role in the trust that the citizens of Louisiana place in governmental agencies. In that moment, they felt their voice had been heard.
Armchair responders
Given past false alarms we try to intentionally delay alerting social media about our deployments until they are already underway. However, in this case, a real deployment happened and we didn't tell our followers until four days in to the response phase.
Once we posted something, most Facebook page fans simply liked or shared the post, with a select few sending comments of prayer and well wishes.
To our surprise, we did receive one comment to the effect of "what took you so long"" This comment likely mirrored the growing frustration with the lack of national media coverage surrounding the flooding.
Rather than delete the comment or block the commenter we choose to respond as diplomatically as possible. Simply stating that we had been deployed since the weekend prior and had been unable to post an update.
The comment was almost instantly deleted by its author.
When being diplomatic doesn't work
As a search and rescue team we are first and foremost responsible for the care of people. Although we have a canine team, many of whom were also deployed, we only assist with an animal rescue should we encounter one in the course of regular operations. We are not trained, nor expected, to seek out rescues geared towards pets, livestock, or other four-legged living beings.
But not everyone knows that.
Once the waters started to recede, two individuals reached out, both attempting to rescue the same group of neglected dogs. Although the dogs weren't in a flooded area, it was obvious they needed help, and these women had taken the initiative — independent of one another — to provide food and water while seeking out an organization that could formally take on the animals.
That's when they found us. And for the next two days we messaged back and forth, explaining that we worked within a structured response system and couldn't "break ranks" to rescue these dogs. At times their frustration with our inability to assist was so apparent they asked for the name of the Operations Section Chief, something we weren't able to provide.
It took a phone call from one of our canine handlers explaining our model of response as well as recommending a number of animal groups conducting rescues in the area to reach a mutual understanding that we weren't the appropriate group. The concerned individuals thanked us for the information and never contacted us again.
A week later we determined that the dogs had been rescued by the original messenger and personally transported to a nearby no-kill shelter. No official rescue groups, animal or human, had been involved in their care.
Lessons learned
Our USAR task force is extremely lucky to have an overwhelmingly supportive group of social media followers. Not only do they include our first responders and their family members, but also strangers from every corner of the globe. That level of support was mirrored during this recent activation from most, if not every, follower.
However, given the similarities that this disaster shared with Hurricane Katrina, both in scope and size, as well as a lack of national media attention and a polarized political response, many of the negative emotions we were facing weren't necessarily directed at us.
But that doesn't mean we shouldn't have been prepared to respond. Because the last thing we want to do is discourage any requests for help.
We now know that managing our Facebook page during this activation would have been significantly less stressful had we incorporated the following:
- Designate one person to handle all social media responses and postings.
- Ensure that no personal contact information is available on the public page.
- Pre-identify contact information that the public can use to request aid.
- Alert our followers to an activation within 24 hours.
- Have an automatic response to Facebook messages.
- Pre-script responses for requests for aid, with the next steps delineated depending on the type of request received.
- Develop a mechanism for determining the timeliness of a second-hand request for aid to avoid any false alarms.
As demonstrated by the thousands of private citizens, better as known as the Cajun Navy, that deployed their boats into the flood waters looking to help with rescues, the people of Louisiana are more than willing to step into action when they feel that the government isn't doing enough. But a lack of responsiveness on social media should never be deemed as the reason why they feel the need to launch out on their own.
We are proud to have been active on social media during the recent flooding and we will continue to improve our utilization of this modern day communication platform to reflect our recent experiences. We owe it to those individuals we have sworn to serve.
About the authors:
Ruel Douvillier spent 20 years in the Army, serving as a medic, infantryman and paratrooper. He spent five years as a paramedic with New Orleans Emergency Medical Services, and 14 years with the New Orleans Fire Department, most of that time with their heavy technical rescue squads. He has also served with private ambulance services and volunteer and combination fire departments. He has extensive experience as an instructor. Ruel is presently the Task Force Leader of the State and Regional USAR team, Louisiana Task Force 1 and the Operations Manager for SAR Specialists, an emergency response training company.
Catherine R. Counts is a doctoral candidate in the department of Global Health Management and Policy at Tulane University School of Public Health and Tropical Medicine where she also previously earned her Master of Health Administration. Counts has research interests in domestic health care policy, quality and patient safety, organizational culture and prehospital emergency medicine. She is a member of AcademyHealth, Academy of Management, the National Association of EMS Physicians, and National Association of EMTs. In her spare time, Counts serves as one of the Canine Managers of the State and Regional USAR team, Louisiana Task Force 1.
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via IFTTT
10 tips for successful online anatomy and physiology instruction
By Dan Limmer
There are some EMT and paramedic education topics, like anatomy and physiology, that we have trouble picturing or conceptualizing how to best teach online. Anatomy and physiology brings to mind long, detailed lectures and labs on things like osmosis and facilitated diffusion.
I believe that many complex topics, including anatomy and physiology, can be taught online or in a hybrid format. Some of the key considerations for effective online instruction include:
1. Make the path and outcomes clear
Students won't know exactly how to learn the A&P material unless you give them a guide. They won't know the depth you want them to learn unless you give them examples.
2. Make it relevant
Relevance supports learning. While certain parts of A&P are largely memorization, most things can be helped along by clinical relevance and balancing facts and figures with a bit of pathophysiology.
3. Offer audio and video resources
Reading and looking at A&P images alone isn't enough. Quick audio podcasts with salient points and short, relevant videos are key to effective instruction. Avoid the temptation to load up on too many videos, GIFs and slide decks. There's a lot out there, and students will have trouble sorting through what is important when time is short.
4. Offer classroom or online follow-up
Students learning this material on their own will need a human safety net. They'll need to bounce things off their peers and an instructor to make sure they are on track. Everyone appreciates having a safety net.
5. Sequence exercises from easy to complex
Consider the cognitive domain when choosing online exercises and assignments, just as you would in the classroom. Start the process with simpler assignments and wrap up an online learning module with more complex assignments and tests. Instructors go wrong by either staying in the middle with instruction of moderate difficulty all the time, or by not matching the assignment with the student's current level of cognitive learning.
Through experience, I believe there are five levels of exercises for online A&P learning:
1. Simple start/refresher
You may think it is too simple to do an exercise in which a student matches a disease to an organ or system, but this eases students in and allows you to see where they stand. Another easy starting exercise would be to ask students to make a crude drawing of the organs in each abdominal quadrant or to label the long bones of a skeleton.
2. Provide a list of diseases and conditions
Give students a list of diseases and have them identify the causative organ or organ system for each disease. Start with some grounders like myocardial infarction and emphysema. Move on to diabetes. Then get a bit more challenging with esophageal varices and cor pulmonale. Your goal should be to have them need to research some of the answers on their own.
3. Facilitated research and note-taking
In this case you are providing the students a list of bullet points and having them fill in the blanks. Do this to guide the students into what they should be learning. You can collect these as assignments if you choose. Students get to research, take notes and get feedback from you, all while creating a lasting study tool. A facilitated research topic might be listing the different components in the immune response (antibody, antigen, mast cells, basophils, histamine, leukotrienes, etc.) and asking your students to describe the role of each of those components.
4. Clinical integration
Add case studies into the mix at this point. This allows students to integrate the first two types of exercises with patient assessment and treatment. Using the immune exercise, give scenarios in which the student would have to predict the chemical mediator or mediators responsible for a patient's signs and symptoms. A potential pitfall would be getting too deep into teaching the immunology portion of the course, but some instruction is OK. Too much takes a lot of time and muddies the waters. A problem-based learning or case-based instruction approach would incorporate more of the immunology at this point.
5. Comprehensive online examinations
Many instructors agonize over whether students use their books when taking online exams. I just assume they do, so I make the questions tougher. As my friend and paramedic educator Joe Mistovich says, "If you want your students to learn comprehensively, you have to test comprehensively." If your test questions are fluff, students won't learn. Testing is more than measurement. It sets the tone for what you want your students to learn and how hard they need to work in all aspects of the course.
My last bit of advice is to get in there and try online A&P instruction. Take a chance. Create some online activities. You'll learn from your first try and improve for the next class.
I'd love to see any specific exercises or hear about your experiences with online A&P. Educators and students may have good and bad experiences to share with me and others in the comments.
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NAEMT accepting nominations to donate to 5 injured EMTs
CLINTON, Miss. — The National Association of Emergency Medical Technicians and a corporate partner are accepting nominations for an injured EMT to receive a financial donation. Nominations close Sept. 5.
The EMS community is encouraged to tell the story of a first responder who was injured in the line of duty in a way that seriously impacted their ability to do their original job. The injury may have occurred at any time during the EMT's career, but they must still be alive and living with the effects of their injury.
Five EMS practitioners who were injured during their career will be considered for a donation.
The practitioner must be willing to share their story through various communications including print, online and social media. In case the EMT is unable to make the decision, a family representative may speak for them.
The head of the recipient's EMS agency must also agree to sharing their story.
Nominations may be submitted by anyone associated with the nominee, such as a fellow EMT, EMS supervisor, a family member or the injured practitioner themselves.
Eligibility for the nomination is open only to emergency responders in U.S. agencies. Local, state and federal responders, as well as career and volunteer responders are eligible.
The following information must be submitted in order to be eligible for the nomination:
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EMT contact info
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Agency contact info
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Supporting information: 700-word narrative about the EMT's injury and up to 3 supporting documents
The deadline for submission of nominations is Labor Day, Monday, Sept. 5. To submit a nomination, complete the online nomination form here.
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First responders report increasing risks on the job
By Patrick Buchnowski
The Tribune-Democrat
PITTSBURGH — Emotions run deep for paramedics.
Saving a life earns gratitude from trauma patients. Losing a life means coping with grief.
Marianne Gontis, of Somerset County, knows this well.
Gontis is supervising paramedic with West End Ambulance Service in Johnstown.
She explains:
"Two years ago I got a letter from a gentleman in Pittsburgh," she said. "It was an amazing letter.
"He was running a marathon in Johnstown when he collapsed at the very end," Gontis said. "He was telling me how well I did my job and how safe he felt. That really meant a lot to me."
As paramedic, she responds to car wrecks, fires, heart attacks, drug overdoses and more. Not all end well.
"When you lose a 2-month-old it rips your heart out," she said.
First responders increasingly see how a heroin overdose can devastate a family.
"A lot of it is drug-related with the families," she said.
"It's not so much the patient because you can usually bring them back. But I see the pain and the hurt they're causing their families."
There also is a discomforting increase is risk to first responders.
West End paramedic Janice Keen Livingston was killed March 2, 2015, when she was struck by a truck while responding to a string of vehicle crashes in icy conditions on state Route 271 in Upper Yoder Township.
More first responders around the country are becoming victims of violence simply for doing their jobs.
Authorities cite an incident in Harrisburg in November 2015 in which a woman lunged at a paramedic with a knife and tried to stab him in the chest.
EMS in Cleveland have instituted a policy requiring paramedics and EMTs to wear bulletproof vests during every call.
West End Ambulance crews now wear body armor.
Gontis said she never thought such protection would be necessary.
"We're here to help people, to get them help no matter who you are or what your situation is," she said.
Gontis recalls an incident about a year ago when an intoxicated man was armed with a handgun.
"When he turned and bent over I saw a gun in his back pocket," she said. "He fell down the stairs drunk."
West End Ambulance Service has about 37 paramedics and EMTs, 11 of them full-time employees.
The service also has five ambulances.
The job of the ambulance service is evolving as more people seek transportation. For some, it's a free trip to the hospital.
Ira Hart, manager of West End Ambulance Service, said many people have few options.
"If you or I am sick we drive to the doctor, but they don't have that option, so they call us," he said. "Is that what we're here for? No, but times have changed and we've had to change too."
Copyright 2016 The Tribune-Democrat
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EMS1 Poll Results: How do you use capnography?
By EMS1 Staff Capnography is increasingly available to EMTs and paramedics for patient assessment and monitoring. Capnography is indicated for patients with traumatic injury, cardiac arrest, sepsis and respiratory compromise. It is also a critical tool to confirm airway insertion and continuously monitor airway placement throughout patient care and transport. We asked EMS1 readers to share their knowledge ...
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Glycosylated hemoglobin as a marker of dyslipidemia in type 2 diabetes mellitus patients in a tertiary care hospital
2016-08-29T07-28-30Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Dharmesh K Patel, Dharmesh N Gamit, Ankur B Patel, Binita H Gohil.
Background: Type 2 diabetes mellitus (DM) is one of the modern pandemics. Evidence has emerged supporting the benefits of glycemic control as well as control of blood pressure and lipid levels in the prevention or delay in onset and severity of complications due to DM. Type 2 DM is a common secondary cause of dyslipidemia, in particular, if glycemic control is poor which, in turn, is an important risk factor for atherosclerosis and coronary heart disease. Glycosylated Hb (HbA1c) is a better indicator of blood glucose as compared to fasting blood glucose and postprandial blood glucose. Aims and Objectives: (i) To know the prevalence of dyslipidemias associated with type 2 DM, (ii) To study the impact of the glycemic status on lipid profile in type 2 DM, (iii) To evaluate the efficacy of HbA1c as a marker of dyslipidemia in type 2 DM. Material and Methods: Patients having diagnosed with Type 2 DM with no clinical evidence of coronary artery disease and more than 40 years old were enrolled in the study. A detailed history with thorough systemic examination was carried out. Hemogram, urinalysis, fasting and blood sugar after 2 h of major meal, HbA1c, lipid profile, chest X-Ray, electrocardiogram, and echocardiogram were performed. Results: About 30% male patients and 47% female patients had HbA1c ≤8% while remaining had HbA1c >8%. 54% patients had low-density lipoprotein (LDL-C)
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The effect of dexmedetomidine pretreatment on the median effective bolus dose of propofol for facilitating laryngeal mask airway insertion
Abstract
Background
We designed this study to investigate the effect of dexmedetomidine (1 μg/kg) pretreatment on the median effective dose (ED50) of propofol for facilitating successful laryngeal mask airway (LMA) insertion compared to propofol alone.
Methods
Forty patients were randomized to either the control group (n = 21) or the dexmedetomidine group (n = 19). After infusion of normal saline or dexmedetomidine 1 µg/kg over 10 min, 1 % lidocaine 0.5 mg/kg, followed by propofol 2.5 mg/kg was administered and the laryngeal mask airway was inserted without muscle relaxants. The ED50 of propofol for successful LMA insertion was determined by the modified Dixon's up-and-down method. The ED50 and ED95 were also calculated using an isotonic regression method, based on the pooled adjacent-violators algorithm-adjusted response rate, and the confidential interval (CI) was estimated using a bootstrap approach.
Results
The ED50 of propofol for smooth insertion of the LMA was significantly higher in the control group than in the dexmedetomidine group (3.1 ± 0.4 vs 1.9 ± 0.3 mg/kg, P < 0.001). From isotonic regression analysis using a bootstrap approach, the ED50 and ED95 of propofol was 2.9 mg/kg (83 % CI 2.5–3.3 mg/kg) and 3.9 mg/kg (95 % CI 3.5–4.0 mg/kg) in the control group, and 1.8 mg/kg (83 % CI 1.8–2.1 mg/kg) and 2.4 mg/kg (95 % CI 2.0–2.5 mg/kg) in the dexmedetomidine groups, respectively. The apnea time was not significantly different between the two groups.
Conclusions
Pretreatment with dexmedetomidine 1 μg/kg could reduce the propofol requirement by 38 % for facilitating LMA insertion without prolonged respiratory depression and hemodynamic instability.
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The effect of single low-dose dexamethasone on vomiting during awake craniotomy
Abstract
Purpose
Intraoperative vomiting leads to serious respiratory complications that could influence the surgical decision-making process for awake craniotomy. However, the use of antiemetics is still limited in Japan. The aim of this study was to investigate the effect of prophylactically administered single low-dose dexamethasone on the incidence of vomiting during awake craniotomy. The frequency of hyperglycemia was also examined.
Methods
We conducted a retrospective case review of awake craniotomy for glioma resection between 2012 and 2015.
Results
Of the 124 patients, 91 were included in the analysis. Dexamethasone was not used in 43 patients and the 48 remaining patients received an intravenous bolus of 4.95 mg dexamethasone at anesthetic induction. Because of stable operating conditions, no one required conscious sedation throughout functional mapping and tumor resection. Although dexamethasone pretreatment reduced the incidence of intraoperative vomiting (P = 0.027), the number of patients who complained of nausea was comparable (P = 0.969). No adverse events related to vomiting occurred intraoperatively. Baseline blood glucose concentration did not differ between each group (P = 0.143), but the samples withdrawn before emergence (P = 0.018), during the awake period (P < 0.0001) and at the end of surgery (P < 0.0001) showed significantly higher glucose levels in the dexamethasone group. Impaired wound healing was not observed in either group.
Conclusion
A single low-dose of dexamethasone prevents intraoperative vomiting for awake craniotomy cases. However, as even a small dose of dexamethasone increases the risk for hyperglycemia, antiemetic prophylaxis with dexamethasone should be administered after careful consideration. Monitoring of perioperative blood glucose concentration is also necessary.
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Hypomorphic MKS1 mutation in a Pakistani family with mild Joubert syndrome and atypical features: Expanding the phenotypic spectrum of MKS1-related ciliopathies
Postaxial polydactyly (PAP) is one of the most common congenital malformations observed in the general population. However, it can also occur as part of a syndrome. Unbiased genetic screening techniques such as exome sequencing are highly appropriate methods to provide a molecular diagnosis in patients with polydactyly due to the large number of mutated genes associated with it. The present study describes a consanguineous family of Pakistani origin with PAP, speech impairment, hearing impairment of variable degree, and proportionate short stature with no prominent intellectual disability or ophthalmological abnormalities. One affected individual of the family was subjected to exome sequencing which resulted in the identification of four homozygous variants including an in-frame deletion (c.1115_1117delCCT; p.(Ser372del) in MKS1, which was later shown to be the only variant segregating with the phenotype. In silico predictions supported the potential pathogenicity of the identified mutation. Additional clinical tests and MRI features of a patient in the family showed a molar tooth sign, which is a hallmark of Joubert syndrome. In conclusion, we have described a pathogenic variant in the MKS1 resulting in a mild Joubert syndrome phenotype, which broadens the spectrum of mutations in the MKS1. © 2016 Wiley Periodicals, Inc.
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Expansion of the variable expression of Muenke syndrome: Hydrocephalus without craniosynostosis
Muenke syndrome (MS) is an autosomal dominant coronal craniosynostosis syndrome with variable extracranial anomalies. We studied 56 unrelated patients with non-syndromic uni- or bicoronal craniosynostosi to identify the frequency and clinical characteristics of MS in a cohort of Mexican childrens. The FGFR3 pathogenic variation p.Pro250Arg responsible for MS was characterized in all probands by PCR-restriction assay; available first-degree relatives (15 parents, 5 siblings) of the confirmed p.Pro250Arg carriers were also tested. All heterozygotes for p.Pro250Arg underwent clinical and audiologic assessment, as well as X-ray evaluations of hands and feet. Eight of 56 probands (14%) were found to carry the p.Pro250Arg variant and half of them were familial cases. Four p.Pro250Arg heterozygous familial members had been considered unaffected before the molecular testing. In one MS family, hydrocephalus without craniosynostosis, was documented as the only clinical manifestation in a previously undetected heterozygous male sibling. Hydrocephalus without craniosynostosis in a patient with the p.Pro250Arg variant suggests that some patients with MS might present only this manifestation; to our knowledge, hydrocephalus has not been described as isolated feature in MS, so we propose to consider this feature as an expansion of the MS phenotype rather than an unrelated finding. Our data also reinforce the notion that molecular testing of FGFR3 must be included in the diagnostic approach of coronal craniosynostosis. This will allow accurate genetic counseling and optimal management of MS, which might otherwise go undiagnosed because of mild manifestations and wide variability of expression. © 2016 Wiley Periodicals, Inc.
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Kabuki syndrome as a cause of non-immune fetal hydrops/ascites
Kabuki syndrome (MIM 147920) is a well-described, multiple congenital anomaly syndrome characterized by growth and developmental delay, cardiac, renal, and vertebral anomalies, as well as persistent fetal finger pads and distinct facial features. Facies are characterized by long palpebral fissures with eversion of lateral third of the lower eyelid, resembling the "Kabuki make-up" theatre genre after which the syndrome is named. Kabuki syndrome is estimated to affect 1/32,000 births, with 55–80% of patients showing nonsense or frameshift mutations in the KMT2D (MLL2) gene, which encodes a histone transferase located on chromosome 12q. Additionally, owing to the heterogeneous nature of Kabuki syndrome, a smaller number of diagnosed patients have been identified with mutations or deletions in KDM6A (a component of the same transcriptional complex as KMT2D) with no mutations in KMT2D, or as those diagnosed with Kabuki syndrome and without alterations in either KMT2D or KDM6A. Diagnosis of the syndrome in newborns and infants is difficult, as the facial features are not as evident as in toddler- or childhood. There are no known "tell-tale" signs of Kabuki syndrome prenatally, and there are no reports of common, specific findings in fetuses that might suggest the diagnosis. We present here two infants who presented with prenatal hydrops/ascites, who were subsequently diagnosed with Kabuki syndrome. Although relatively non-specific, we suggest that Kabuki syndrome be added to the list of genetic syndromes that are suspected in cases of prenatal hydrops, review the molecular etiology of Kabuki syndrome, and broaden the phenotype of this well-described disorder. © 2016 Wiley Periodicals, Inc.
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Posttraumatic levels of liver enzymes can reduce the need for CT in children: A retrospective cohort study
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery
BMC Gastroenterology
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Simple predictive model for identifying patients with chronic hepatitis C and hepatitis C virus genotype 4 infection with a high probability of sustained virologic response with peginterferon alfa-2a/ribavirin: Pooled analysis of data from two large, international cohort studies
Advances in Therapy
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An indirect comparison of infliximab versus adalimumab or golimumab for active ulcerative colitis
Archives of Medical Science
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Prevalent vs. incident oesophageal adenocarcinoma and high-grade dysplasia in Barrett's oesophagus
Alimentary Pharmacology and Therapeutics
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Operative techniques to avoid near misses during laparoscopic hepatectomy
Surgery
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Prevention of progression to cirrhosis in hepatitis C with fibrosis: Effectiveness and cost effectiveness of sequential therapy with new direct-acting anti-virals
Alimentary Pharmacology and Therapeutics
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Lay educators help boost colorectal screening rates in Hmong
UC Davis Health System
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Efficacy and safety of irinotecan monotherapy as third-line treatment for advanced gastric cancer
Cancer Chemotherapy and Pharmacology
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Risks factors for severe pain after selective liver transarterial chemoembolization
Liver International
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Effects of increasing screening age and fecal hemoglobin cut-off concentrations in a colorectal cancer screening program
Clinical Gastroenterology and Hepatology
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The expression of microRNA 574-3p as a predictor of postoperative outcome in patients with esophageal squamous cell carcinoma
World Journal of Surgical Oncology
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Trifluridine/tipiracil: a review in metastatic colorectal cancer
Drugs
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Magnetic resonance enterography in the study of patients with crohns disease: which findings are more likely to change patient management?
Canadian Association of Radiologists Journal
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A novel technique for the endoscopic treatment of complete biliary anastomosis obstructions after liver transplantation: Through-the-scope magnetic compression anastomosis
Gastrointestinal Endoscopy
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Dietary factors associated with metabolic syndrome and its components in overweight and obese Brazilian schoolchildren: a cross-sectional study
Diabetology & Metabolic Syndrome
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Application and verification of quantitative objective videofluoroscopic swallowing measures in a pediatric population with dysphagia
The Journal of Pediatrics
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Precision medicine has applications for pancreatic cancer
University of Arizona Health News
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HCN channels segregate stimulation-evoked movement responses in neocortex and allow for coordinated forelimb movements in rodents
Abstract
The mechanisms by which distinct movements of a forelimb are generated from the same area of motor cortex have remained elusive. Here we examined a role for HCN channels, given their ability to alter synaptic integration, in the expression of forelimb movement responses during intracortical microstimulation (ICMS) and movements of the forelimb on a skilled reaching task. We used short-duration high resolution ICMS to evoke forelimb movements following pharmacological (ZD7288), experimental (electrically induced cortical seizures) or genetic approaches that we confirmed with whole-cell patch clamp to substantially reduce Ih current. We observed significant increases in the number of multiple movement responses evoked at single sites in motor maps to all 3 experimental manipulations in rats or mice. HCN1KO mice were less successful and exhibited atypical movements on a skilled-motor learning task relative to wild-type controls. Furthermore, in reaching-proficient rats, reaching accuracy was reduced and forelimb movements were altered during infusion of ZD7288 within motor cortex. Thus, HCN channels play a critical role in the separation of overlapping movement responses and allow for successful reaching behaviours. These data provide a novel mechanism for the encoding of multiple movement responses within shared networks of motor cortex. This mechanism supports a viewpoint of primary motor cortex as a site of dynamic integration for behavioural output.
This article is protected by copyright. All rights reserved
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Extremely high radon activity concentration in two adits of the abandoned uranium mine ‘Podgórze’ in Kowary (Sudety Mts., Poland)
Source:Journal of Environmental Radioactivity, Volume 165
Author(s): Lidia Fijałkowska–Lichwa
Measurements of radon activity concentration were conducted for a period of 6 months, from April to September 2011, in the air of two adits constituting part of the disused uranium mine 'Podgórze' in Kowary. Adits no. 19 and 19a in Kowary had been chosen owing to the occurrence within them of the highest documented radon concentrations in Poland, With levels higher than a million Bq m−3.The main goal of this study was to characterize the level of 222Rn activity concentration registered in selected workings of this underground space, investigate 222Rn changes and their characteristics over selected periods of time (an hour, a day, a month, six months) and determine the effective doses, which provided the basis for estimating the risk of exposure to increased ionizing radiation for employees and visitors to the mine.The highest values of 222Rn activity concentration inside the adits occurred at the time when visitors, guides and other members of the staff were present there. The recorded values of radon activity concentration, regardless of the time and the month when the measurement was performed, remained at an average level of 350–400 kBq m−3. These values were far above the limit of 1.5 kBq·m−3 recommended by international guidelines. The maximum values ranged from 800 to more than 1000 kBq·m−3.Radon activity concentration changes occurred only in periods determined by 7-h cycles of connecting and disconnecting the mechanical ventilation. For about 7 h after activating the ventilation system, between 7 a. m. and 2 p. m., and after closing the adit, between 7 p. m. and 2 a. m., 222Rn activity concentrations decreased to levels even as low as 100 kBq·m-3. However, as early as 3–4 h after disconnecting the ventilation system, there was a sharp rise in the values of 222Rn activity concentration, to the level higher than 800 kBq·m-3.The risk of receiving a radiation dose higher than the national standard of 1 mSv/year by members of the public occurred as soon as after spending 1 h inside the workings. The minimum monthly effective radiation dose received by every employee in the tourist adit no. 19 in Kowary was higher than 1/5 (4 mSv) of the annual effective dose allowed by Polish law (20 mSv/year). In the non-tourist adit no. 19, the minimum monthly radiation dose was more than 3 times as high as the allowed value of 4 mSv.Due to the highly disturbing and unfavourable, from a radiological protection point of view, conditions inside the disused uranium mine 'Podgórze' in Kowary, the mine manager decided to increase the efficiency of the designed mechanical ventilation system and launch measurements of radon activity concentration in the workplace.
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A tool for calculating concentration ratios from large environmental datasets
Source:Journal of Environmental Radioactivity, Volume 165
Author(s): Che Doering, Andreas Bollhöfer
This paper presents a tool for calculating concentration ratios from a large and structured environmental dataset of radionuclide activity and metal concentrations. The tool has been developed in MS Excel™ and includes a simple user interface for setting up queries. The tool is capable of matching environmental media samples to biota samples based on user-defined spatial and temporal criteria to derive a representative estimate of the environmental exposure conditions of an organism and its accumulation. Some potential benefits and uses of the tool are discussed.
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Anthropogenic and naturally occurring radionuclide content in near surface air in Cáceres (Spain)
Source:Journal of Environmental Radioactivity, Volume 165
Author(s): Antonio Baeza, Antonio Rodríguez-Perulero, Javier Guillén
The anthropogenic (137Cs, 90Sr, 239+240Pu and 241Am) and naturally occurring radionuclide (40K, 234,238U, 228,230,232Th, 226Ra and 210Pb) content in near surface air present seasonal variations related to natural processes, such as soil erosion, resuspension of fine particles of soil and radon exhalation from soil (210Pb). The objective is to analyze seasonal variations of their concentrations and compare with radiological events (Fukushima fallout and wild fire) in a location without any known source of anthropogenic radionuclides. The 210Pb, 40K, and 137Cs presented annual variations, with maximum activity levels in summer. Solar radiation and rainfall were correlated with 210Pb and 40K. The 234,238U, 228,230,232Th, 226Ra, 137Cs and 90Sr presented positive correlation with monthly mean values of temperature. The ratio 90Sr/137Cs was within the range of those reported for soils in Spain. Finally, the maximal effective dose rate was estimated to be 37 and 88 μSv/y for infants and adults, respectively, well below 1 mSv/y reference level. The main contributor to effective dose was 210Pb, about 92%, followed by:210Pb ≫ 228,230,232Th > 226Ra, 234,238U > 7Be, 239+240Pu > 40K, 90Sr > 137Cs > 22Na
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Impacts on the terrestrial environment in case of a hypothetical accident involving the recovery of the dumped Russian submarine K-27
Source:Journal of Environmental Radioactivity, Volume 165
Author(s): J.E. Brown, I. Amundsen, J. Bartnicki, M. Dowdall, J.E. Dyve, A. Hosseini, H. Klein, W. Standring
Objects containing radioactivity have been routinely dumped in Arctic waters near NW Russia up until the 1990s. One of the most radioactive objects in this region, the nuclear submarine K-27, was dumped in Stepogovo Fjord and contained spent nuclear fuel (SNF). Although the two K-27 submarine reactors were mothballed before dumping, concerns about the potential long term risks of contamination remain and plans to retrieve and decommission K-27 exist. In this article, human dose and environmental impact aseessments are presented for two possible future scenarios involving: (1) an ingress of water into a reactor in situ leading to a spontaneous chain reaction (SCR) and (2) an on-board fire when SNF is being removed at the mainland decommissiong site at Gremhika Bay on the Kola Peninsula. Assessments have been completed using conservative assumptions, focusing on possible effects to Norwegian territory. Atmospheric transport and deposition of radioactivity was modelled near field and regionally, using appropriate models, whilst human doses and environmental exposures were modelled using a standard IAEA approach and the ERICA tool, respectively. Results indicate that large areas of Norwegian territory could be affected by fallout from the Gremhika scenario, especially in the north, though at levels two orders of magnitude lower than those observed after the Chernobyl accident. Potential doses, primarily due to ground shine, to a critical group of personnel on-site at Stepogovo resulting from a SCR could require preventative measures based on ICRP recommendations (20–100 mSv). Doses to non-human biota in Norway for the Gremhika scenario would be negligible, typical of background dose rates for terrestrial organisms.
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A novel familial autosomal dominant mutation in ARID1B causing neurodevelopmental delays, short stature, and dysmorphic features
Recent studies have identified mutations in the ARID1B gene responsible for neurodevelopmental delays, intellectual disability, growth delay, and dysmorphic features. ARID1B encodes a subunit of the BAF chromatin-remodeling complex, and mutations in multiple components of the BAF complex have been implicated as causes of Coffin–Siris syndrome, Nicolaides–Baraitser syndrome, and non-syndromic intellectual disability. The majority of documented pathogenic ARID1B mutations to date have arisen in a sporadic, de novo manner with no reports of inheritance of a pathogenic mutation from an affected parent. We describe here two patients (a 21-year-old female and her 21-month-old son) with a novel frameshift mutation in ARID1B inherited in an autosomal dominant fashion in the affected offspring. Both patients presented with neurodevelopmental delays, growth delay, and dysmorphic features including prominent nose with full nasal tip, long philtrum, and high-arched palate. Exome sequencing analysis in the female patient demonstrated a heterozygous deletion of nucleotide 1259 of the ARID1B gene (c.1259delA) resulting in a frameshift and creation of a premature stop codon. Further family testing by targeted Sanger sequencing confirmed that this arose as a de novo mutation in the mother and was passed on to her affected son. The clinical features of both patients are felt to be consistent with an ARID1B-related disorder. To our knowledge, this is the first report of a pathogenic mutation in ARID1B being passed from an affected parent to their offspring. © 2016 Wiley Periodicals, Inc.
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Maternal hypertension and risk for hypospadias in offspring
Hypospadias is one of the most common birth defects in male infants. Maternal hypertension is a suspected risk factor; however, few previous studies have addressed the possibility of reporting bias, and several previous studies have not accounted for hypospadias severity. We analyzed data from the Texas Birth Defects Registry for 10,924 nonsyndromic cases and statewide vital records for deliveries during 1999–2009, using Poisson regression. After adjustment for potential confounders, hypospadias was associated with maternal hypertension (adjusted prevalence ratio: 1.5, 95% confidence interval: 1.4–1.7). Similar associations were observed with gestational and pregestational hypertension, including separate analyses restricted to the subset of cases with severe (second- or third-degree) hypospadias. All of these associations were also similar among the subset of cases with isolated hypospadias (without additional birth defects). To evaluate the potential for bias due to potential hypertension misclassification, we repeated our analyses using logistic regression, comparing the cases to controls with other birth defects. In these analyses, the associations with gestational hypertension were similar, but adjusted associations with pregestational hypertension were no longer observed. Our findings support an association between gestational hypertension and hypospadias in offspring, but also suggest that previously observed associations with pregestational hypertension may have been inflated due to differential misclassification of hypertension (e.g., reporting bias). As gestational hypertension is recognized after hypospadias development, more research is needed to determine if this association reflects an increase in gestational hypertension risk secondary to hypospadias or if both conditions have shared risk factors (e.g., precursors of gestational hypertension). © 2016 Wiley Periodicals, Inc.
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