Stress in the Prehospital EMS and Disaster Setting

1991 ◽  
Vol 6 (4) ◽  
pp. 483-484 ◽  
Author(s):  
Susan D. McHenry
Keyword(s):  
Emergency Services ◽  
The United States ◽  
Mass Casualty ◽  
Quarter Century ◽  
Complex Issue ◽  
The Past ◽  
Emergency Service Personnel ◽  
Public Safety Personnel ◽  
Area Of Concern ◽  
The Impact

While formal efforts have been made during the past quarter century in the United States to develop and coordinate emergency medical services (EMS) as a “system” of care, it was not until the past decade that we began to recognize and acknowledge the impact of stress on the lives of EMS and other public safety personnel, in both normal day-to-day response to emergencies as well as response to mass casualty incidents or disasters. The first significant writing on this complex issue, Emergency Response to Crisis, by Jeffrey T. Mitchell, PhD and H. L. P. Resnik, MD, provided a crisis intervention guidebook for emergency service personnel and early insight on crisis-worker stress and burnout. The most recent comprehensive discussion of this important area of concern can be found in Emergency Services Stress, by Mitchell and Grady Bray, PhD.

Evaluating the impact of decontamination interventions performed in sequence for mass casualty chemical incidents

2021 ◽  
Author(s):  
Samuel Collins ◽  
Natalie Williams ◽  
Felicity Southworth ◽  
Thomas James ◽  
Louise Davidson ◽  
...  
Keyword(s):  
Vegetable Oil ◽  
Methyl Salicylate ◽  
Emergency Services ◽  
Mass Casualty ◽  
Human Volunteer ◽  
Additional Contribution ◽  
Uv Photography ◽  
Chemical Incidents ◽  
The Impact ◽  
Control Skin

Abstract The Initial Operational Response (IOR) to chemical incidents is a suite of rapid strategies including evacuation, disrobe and improvised and interim decontamination. IOR and Specialist Operational Response (SOR) decontamination protocols involving mass decontamination units would be conducted in sequence by UK emergency services following a chemical incident, to allow for safe onward transfer of casualties. As part of a series of human volunteer studies, we examined the effectiveness of IOR and SOR decontamination procedures alone and in sequence. Specifically, we evaluated the additional contribution of SOR, when following improvised and interim decontamination. Two simulants, methyl salicylate (MeS) with vegetable oil and benzyl salicylate (BeS), were applied to participants’ skin. Participants underwent improvised dry, improvised wet, interim wet, specialist decontamination and a no decontamination control. Skin analysis and UV photography indicated significantly lower levels of both simulants remaining following decontamination compared to controls. There were no significant differences in MeS levels recovered between decontamination conditions. Analysis of BeS, a more persistent simulant than MeS, showed that recovery from skin was significantly reduced following combined IOR with SOR than IOR alone. These results show modest additional benefits of decontamination interventions conducted in sequence, particularly for persistent chemicals, supporting current UK operational procedures.

Ascesa e declino dell'editoria psicoanalitica americana

2009 ◽  
pp. 9-46
Author(s):  
Paul E. Stepansky
Keyword(s):  
World War Ii ◽  
Book Publishing ◽  
The United States ◽  
Erik Erikson ◽  
World War ◽  
Erich Fromm ◽  
Quarter Century ◽  
The Past ◽  
Karen Horney ◽  
Internal Fragmentation

- The rise and fall of psychoanalytic book publishing in America is one sign of the progressive marginalization of psychoanalysis within American mental health care. The "glory era" of psychoanalytic book publishing, roughly the quarter century following the end of World War II, is described. This was the era when psychoanalyst-authors such as Karl Menninger, Erich Fromm, Erik Erikson, and Karen Horney published books of great commercial success. Cumulative sales data of noteworthy psychoanalytic books published in the United States over the past 70 years are reported, and document the continuous decline in sales since the 1970s. In accounting for the recent acceleration of this decline, Stepansky focuses on the internal fragmentation of a once cohesive profession into rival schools with sectarian features, each committed to a self-limited reading agenda. Stepansky discusses these issues from his vantage point as Managing Director of The Analytic Press from 1984-2006. [KEY WORDS: American psychoanalysis, publishing, books, fractionation, marginalization]

scholarly journals Monetary Policy and Inequality

2020 ◽  
Vol 12 (4) ◽  
pp. 006-017
Author(s):  
Alexander A. Rakviashvili ◽  
Keyword(s):  
Monetary Policy ◽  
Wealth Inequality ◽  
The United States ◽  
Central Banks ◽  
Distribution Of Wealth ◽  
The Past ◽  
High Propensity ◽  
Debt Market ◽  
The Impact ◽  
American Economy

The article provides a literature review of studies of the impact of monetary policy on income and wealth inequality. Based on the analysis and systematization of the articles mainly written over the past 25–30 years as well as articles written by central bank authorities, the main approaches to assessing the extent to which the Fed's actions are responsible for the growth of wealth inequality in the United States, which began in the 1970s, are identified. It was revealed that the relative unanimity of economists on this issue was replaced by significant pluralism of opinions after the crisis of 2007–2009. Among other reasons this was caused by the activity of central banks and their use of non-conventional approaches in conducting the monetary policy. In addition, the channels through which the actions of central banks affect the distribution of wealth in the economy are identified. In total, five such channels were singled out. Thus, changes in the monetary policy affect the debt market and the structure of assets and liabilities of households, while households with fixed incomes and with a high propensity to use cash are more likely to suffer losses during the expansionary monetary policy. And the fifth channel, which is less popular among the economists, the "Cantillon effect", leads to an increase in the wealth of the first recipients of the issued money at the expense of those who are farthest from the center of emission. The article provides empirical evidence of why this effect is significant for the American economy, and theoretical arguments indicating that taking the Cantillon effect into account can add certainty to studies of both monetary policy costs and institutional changes caused by rising inequality.

scholarly journals Taken by Storm: Hurricanes, Migrant Networks, and US Immigration

2020 ◽  
Vol 12 (2) ◽  
pp. 250-277 ◽  
Author(s):  
Parag Mahajan ◽  
Dean Yang
Keyword(s):  
Climate Change ◽  
United States ◽  
International Migration ◽  
The United States ◽  
Quarter Century ◽  
Migrant Networks ◽  
Disaster Impacts ◽  
The Impact ◽  
Natural Disaster Impacts ◽  
Us Immigration

Do negative shocks in origin countries encourage or inhibit international migration? What roles do networks play in modifying out-migration responses? The answers to these questions are not theoretically obvious, and past empirical findings are equivocal. We examine the impact of hurricanes on a quarter century of international migration to the United States. Hurricanes increase migration to the United States, with the effect’s magnitude increasing in the size of prior migrant stocks. We provide new insights into how networks facilitate legal, permanent US immigration in response to origin country shocks, a matter of growing importance as climate change increases natural disaster impacts. (JEL F22, J15, Q54, Z13)

scholarly journals Patterns of Change in ACGME-Accredited Residency Programs and Positions: Implication for the Adequacy of GME Positions and Supply of Physicians in the United States

2014 ◽  
Vol 6 (2) ◽  
pp. 399-403 ◽  
Author(s):  
Kathleen D. Holt ◽  
Rebecca S. Miller ◽  
Ingrid Philibert ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Graduate Medical Education ◽  
Primary Care Physicians ◽  
Population Data ◽  
The United States ◽  
Graduate Medical ◽  
The Past ◽  
Accredited Institutions ◽  
The Impact

Abstract Background Recent studies suggest that the supply of primary care physicians and generalist physicians in other specialties may be inadequate to meet the needs of the US population. Data on the numbers and types of physicians-in-training, such as those collected by the Accreditation Council for Graduate Medical Education (ACGME), can be used to help understand variables affecting this supply. Objective We assessed trends in the number and type of medical school graduates entering accredited residencies, and the impact those trends could have on the future physician workforce. Methods Since 2004, the ACGME has published annually its data on accredited institutions, programs, and residents to help the graduate medical education community understand major trends in residency education, and to help guide graduate medical education policy. We present key results and trends for the period between academic years 2003–2004 and 2012–2013. Results The data show that increases in trainees in accredited programs are not uniform across specialties, or the types of medical school from which trainees graduated. In the past 10 years, the growth in residents entering training that culminates in initial board certification (“pipeline” specialties) was 13.0%, the number of trainees entering subspecialty education increased 39.9%. In the past 5 years, there has been a 25.8% increase in the number of osteopathic physicians entering allopathic programs. Conclusions These trends portend challenges in absorbing the increasing numbers of allopathic and osteopathic graduates, and US international graduates in accredited programs. The increasing trend in subspecialization appears at odds with the current understanding of the need for generalist physicians.

Seismic Design Requirements for Regions of Moderate Seismicity

2000 ◽  
Vol 16 (1) ◽  
pp. 205-225 ◽  
Author(s):  
Guy J. P. Nordenson ◽  
Glenn R. Bell
Keyword(s):  
United States ◽  
Seismic Design ◽  
Soft Soil ◽  
The United States ◽  
Mitigation Measures ◽  
Quarter Century ◽  
Seismic Codes ◽  
The Past ◽  
Moderate Seismicity ◽  
High Seismicity

The need for earthquake-resistant construction in areas of low-to-moderate seismicity has been recognized through the adoption of code requirements in the United States and other countries only in the past quarter century. This is largely a result of improved assessment of seismic hazard and examples of recent moderate earthquakes in regions of both moderate and high seismicity, including the San Fernando (1971), Mexico City (1985), Loma Prieta (1989), and Northridge (1994) earthquakes. In addition, improved understanding and estimates of older earthquakes in the eastern United States such as Cape Ann (1755), La Malbaie, Quebec (1925), and Ossippe, New Hampshire (1940), as well as monitoring of micro-activity in source areas such as La Malbaie, have increased awareness of the earthquake potential in areas of low-to-moderate seismicity. Both the hazard and the risk in moderate seismic zones (MSZs) differ in scale and kind from those of the zones of high seismicity. Earthquake hazards mitigation measures for new and existing construction need to be adapted from those prevailing in regions of high seismicity in recognition of these differences. Site effects are likely to dominate the damage patterns from earthquakes, with some sites suffering no damage not far from others, on soft soil, suffering near collapse. A number of new seismic codes have been developed in the past quarter century in response to these differences, including the New York City (1995) and the Massachusetts State (1975) seismic codes. Over the same period, the national model building codes that apply to most areas of low-to-moderate seismicity in the United States, the Building Officials and Code Administrators (BOCA) Code and the Southern Standard Building Code (SSBC), have incorporated up-to-date seismic provisions. The seismic provisions of these codes have been largely inspired by the National Earthquake Hazard Reduction Program (NEHRP) recommendations. Through adoption of these national codes, many state and local authorities in areas of low-to-moderate seismicity now have reasonably comprehensive seismic design provisions. This paper will review the background and history leading up to the MSZ codes, discuss their content, and propose directions for future development.

Greening the Gulag: Austerity, neoliberalism, and the making of the “green prisoner”

2019 ◽  
Vol 3 (4) ◽  
pp. 1120-1136
Author(s):  
B Jewell Bohlinger
Keyword(s):  
United States ◽  
Prison Population ◽  
Cost Effective ◽  
Mass Incarceration ◽  
The United States ◽  
Effective Strategies ◽  
The Past ◽  
Cost Cutting ◽  
Important Challenge ◽  
The Impact

Over the past 30 years the U.S. prison population has exploded. With the impact of climate change already here, we are also seeing new critiques of mass incarceration emerge, namely their environmental impact. In response to these burgeoning critiques as well as calls to action by the Justice Department to implement more sustainable and cost-effective strategies in prisons, the United States is experiencing a surge in prison sustainability programs throughout the country. Although sustainability is an important challenge facing the world, this paper argues that while “greening” programs seem like attempts to reform current methods of imprisonment, sustainability programming is an extension of the neoliberalization of incarceration in the United States. By emphasizing cost cutting while individualizing rehabilitation, prisons mobilize sustainability programming to produce “green prisoners” who are willing to take responsibility for their rehabilitation and diminish their economically burdensome behaviors (i.e. excessive wastefulness). Using semi-structure journals and interviews at three Oregon prisons, this paper investigates these ideas through the lens of the Sustainability in Prisons Project.

Ethnicity Significantly Influences Incidence Patterns and Predicts Mortality: Adult Hodgkin Lymphoma (HL) In the United States (US)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2683-2683
Author(s):  
Andrew M Evens ◽  
Eileen Shiuan ◽  
Soyang Kwon ◽  
Leo I Gordon ◽  
Brian Chiu
Keyword(s):  
Mortality Rate ◽  
Conflicts Of Interest ◽  
The United States ◽  
Annual Percent Change ◽  
Black Females ◽  
The Past ◽  
Seer Data ◽  
Black Populations ◽  
And Gender ◽  
The Impact

Abstract Abstract 2683 Background: Pediatric HL studies have suggested survival differences based on ethnicity. However, little data is available regarding the impact, if any, of ethnicity on incidence patterns, disease histology, and/or survival among adult HL. Methods: We examined data for 13 US SEER areas, several of which contain large Hispanic and Black populations. Case information was obtained from the 11/2009 SEER data submission released April 2010. We analyzed incidence, HL histology, and mortality rates according to ethnicity, age, and gender. We also examined incidence patterns across the past four decades. All analyses used SEER*Stat. Results: A total of 16,783 HL cases were diagnosed among residents in the 13 SEER registry areas during 1992–2007, with non-Hispanic Whites contributing the largest number (n=11,890), followed by Hispanics (n=2,190), and Blacks (n=1,724). Consistent with SEER 9 results (1973 data), Whites show a continued bimodal age-incidence curve (6.0/100,000 ages 25–29, 2.5/100,000 ages 50–54, and 4.5/100,000 age 75–79). However, Blacks have a much less apparent bimodal pattern (4.5/100,000 ages 25–29, 2.6/100,000 ages 50–54, and 3.0/100,000 ages 75–79), while Hispanics are distinctly not bimodal with a small increase at 20–24 (2.4/100,000) followed by an exponential-like increase with peak HL incidence at ages 80–84 (7.0/100,000). Moreover, among persons >65 years, HL is currently significantly more common in Hispanics than Whites (4.7-7.0/100,000 vs 3.9–4.5/100,000, respectively, p<0.05). With gender, HL is more common in males than females, regardless of ethnicity. Interestingly, the male excess, however, does not occur until ages 30–34 (all ethnicities). Furthermore, from 1975–2007, HL incidence increased in Black females (annual percent change (APC) = 2.5; p<0.05) and White females (APC = 0.4; p<0.05). According to histology, both nodular sclerosis and mixed cellularity are more common in Whites followed by Blacks and Hispanics, while in persons age 60–84, both histologies are significantly more common in Hispanics compared with Whites and Blacks. Over the past 20 years, mortality has declined within each race by 10.3%–13.7% (p<0.05). However, age-specific ethnic survival disparities are apparent (Figure 1). For ages 65–84, Hispanics have a significantly increased mortality rate compared with Whites/Blacks (p<0.05). Conversely, among ages 20–44, Hispanics have a lower mortality rate versus Whites and Blacks. Conclusions: Multiple important epidemiologic and mortality differences are evident across and within ethnicities in adult HL. *Both sexes (1992-2007). Rates are per 100,000. Mortality source: US Mortality Files, National Center for Health Statistics, CDC. Accessed August 12th, 2010. Disclosures: No relevant conflicts of interest to declare.

Protestantism in Twentieth-Century Chinese America: The Impact of Transnationalism on the Chinese Diaspora

2006 ◽  
Vol 13 (1-2) ◽  
pp. 121-148 ◽  
Author(s):  
Timothy Tseng
Keyword(s):  
World War Ii ◽  
Chinese American ◽  
Chinese Americans ◽  
The United States ◽  
Chinese Diaspora ◽  
World War ◽  
The Past ◽  
American Protestantism ◽  
The Impact ◽  
Protestant Denominations

AbstractThis article examines how an indigenous form of evangelicalism became the predominant form of Chinese Protestantism in the United States since 1949. Chinese-American Protestantism was so thoroughly reconstructed by separatist immigrants from the Diaspora and American-born (or American-raised) evangelicals that affiliation with mainline Protestant denominations and organizations is no longer desired. This development has revitalized Chinese-American Protestantism. Indeed, Chinese evangelicalism is one of the fastest-growing religions in China, the Chinese Diaspora, and among Chinese in America. Though the percentage of Chinese Americans affiliated with Christianity is not nearly as high as that of Korean Americans, Chinese-American Protestantism has achieved impressive numeric growth over the past fifty years. Much of this growth can be attributed to the large number of Chinese who have migrated to North America since World War II.

scholarly journals Business With China: A Critical Evaluation Of Lure And Challenges

2011 ◽  
Vol 8 (2) ◽  
Author(s):  
Mohamad Sepehri ◽  
Hassan Pordeli
Keyword(s):  
Economic Growth ◽  
Economic Development ◽  
Critical Evaluation ◽  
Market Reform ◽  
Economic Power ◽  
Quarter Century ◽  
The Past ◽  
Doing Business ◽  
Business Opportunities ◽  
The Impact

This paper examines the significant historical and socio economic development in China over the past quarter century and summarizes the main features of the pre-reform economy and the main strategies adopted by china as it began its quest for economic progress. The paper also evaluates the consequences of Chinas market reform and the challenges to this new economic power. The objective of the paper is to discuss both opportunities and risks in doing business in China and to provide and understanding of what compels so many firms to so boldly seek to establish a presence in China while taking substantial risks in doing so. The research concludes that, investment and business opportunities in China would outweigh the risk and challenges faced by potential investors. The paper examines the elements contributing to Chinas reform, including pro market reform, economic growth, and the rate and significance of FDI in china. Investment challenges include: corruption, mostly unfree economy, low ranking in ease of doing business, undervalued Yuan, and lack of proper intellectual property rights. The research points to positive indicators such as: Chinas economic development growth (i.e. GDP growth at 9.9% in mainland and 12.4% in Zhejiang); Chinas entry in WTO relaxing foreign investment restrictions; infrastructure development transit, energy, telecommunications, etc.; and the impact of the market reform - Chinas economic growth rate among the highest recorded during the past three decades. The examination of risks and challenges, reveals (1) the Driving Forces for business investment in China which include: rapidly expanding economy; growth in Chinese consumer purchasing power; and economic Power & other Indicators; and (2) the issues of concern such as: excess capacity in industrial sector, export dependence economy, problem with banking sector, and potential unemployment problem. The paper concludes that despite potential and clear risks there are good and legitimate business and investment potential in China and among many factors to consider are: many incentives to consider business opportunities and potential benefits; rising personal income and spending power in China; and increase in per capita income at steady rate of 8% since 1980, currently estimated at $3000.

Sign in / Sign up

Export Citation Format

Share Document