scholarly journals BITES study: A qualitative analysis among emergency medicine physicians on snake envenomation management practices

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262215
Author(s):  
Anna Tupetz ◽  
Loren K. Barcenas ◽  
Ashley J. Phillips ◽  
Joao Ricardo Nickenig Vissoci ◽  
Charles J. Gerardo
Keyword(s):  
United States ◽  
Emergency Medicine ◽  
Financial Burden ◽  
The United States ◽  
Poison Center ◽  
Functional Impairments ◽  
Major Barrier ◽  
Snake Envenomation ◽  
Depth Interviews

Introduction Antivenom is currently considered standard treatment across the full spectrum of severity for snake envenomation in the United States. Although safe and effective antivenoms exist, their use in clinical practice is not universal. Objective This study explored physicians’ perceptions of antivenom use and experience with snake envenomation treatment in order to identify factors that influence treatment decisions and willingness to administer. Methods We conducted a qualitative study including in-depth interviews via online video conferencing with physicians practicing in emergency departments across the United States. Participants were selected based on purposive sampling methods. Data analysis followed inductive strategies, conducted by two researchers. The codebook and findings were discussed within the research team. Findings Sixteen in-depth interviews with physicians from nine states across the US were conducted. The participants’ specialties include emergency medicine (EM), pediatric EM, and toxicology. The experience of treating snakebites ranged from only didactic education to having treated over 100 cases. Emergent themes for this manuscript from the interview data included perceptions of antivenom, willingness to administer antivenom and influencing factors to antivenom usage. Overall, cost-related concerns were a major barrier to antivenom administration, especially in cases where the indications and effectiveness did not clearly outweigh the potential financial burden on the patient in non-life- or limb-threatening cases. The potential to decrease recovery time and long-term functional impairments was not commonly reported by participants as an indication for antivenom. In addition, level of exposure and perceived competence, based on prior education and clinical experience, further impacted the decision to treat. Resources such as Poison Center Call lines were well received and commonly used to guide the treatment plan. The need for better clinical guidelines and updated treatment algorithms with clinical and measurable indicators was stated to help the decision-making process, especially among those with low exposure to snake envenomation patients. Conclusions A major barrier to physician use of antivenom is a concern about cost, cost transparency and cost–benefit for the patients. Those concerns, in addition to the varying degrees of awareness of potential long-term benefits, further influence inconsistent clinical treatment practices.

BITES study: A qualitative analysis among emergency medicine physicians on Snake Envenomation Management practices

2021 ◽  
Author(s):  
Joao Ricardo Nickenig Vissoci
Keyword(s):  
United States ◽  
Emergency Medicine ◽  
Financial Burden ◽  
The United States ◽  
Poison Center ◽  
Functional Impairments ◽  
Major Barrier ◽  
Snake Envenomation ◽  
Depth Interviews

Introduction: Antivenom is currently considered standard treatment across the full spectrum of severity for snake envenomation in the United States. Although safe and effective antivenoms exist, their use in clinical practice is not universal.Objective: This study explored physicians’ perceptions of antivenom use and experience with snake envenomation treatment in order to identify factors that influence treatment decisions and willingness to administer.Methods: We conducted a qualitative study based on a grounded theory framework including in-depth interviews via online video conferencing with physicians practicing in emergency departments across the United States. Participants were selected based on purposive sampling methods. Data analysis followed a combination of inductive and deductive strategies, conducted by two researchers. The codebook and findings were discussed within the research team. Findings: Sixteen in-depth interviews with physicians from nine states across the US were conducted. The participants’ specialties include emergency medicine (EM), pediatric EM, and toxicology. The experience of treating snakebites ranged from only didactic education to having treated over 100 cases. Emergent themes for this manuscript from the interview data included perceptions of antivenom, willingness to administer antivenom and influencing factors to antivenom usage. Overall, cost-related concerns were a major barrier to antivenom administration, especially in cases where the indications and effectiveness did not clearly outweigh the potential financial burden on the patient in non-life- or limb-threatening cases. The potential to decrease recovery time and long-term functional impairments was not commonly reported by participants as an indication for antivenom. In addition, level of exposure and perceived competence, based on prior education and clinical experience, further impacted the decision to treat. Resources such as Poison Center Call lines were well received and commonly used to guide the treatment plan. The need for better clinical guidelines and updated treatment algorithms with clinical and measurable indicators was stated to help the decision-making process, especially among those with low exposure to snake envenomation patients.Conclusions: A major barrier to physician use of antivenom is a concern about cost, cost transparency and cost–benefit for the patients. Those concerns, in addition to the varying degrees of awareness of potential long-term benefits, further influence inconsistent clinical treatment practices.

“No Way! Like Only Hispanics are Illegal”: Examining the Racialized Psychosocial Development of Migrant “Illegality” Across Immigrant Groups in the United States

2022 ◽  
pp. 074355842110641
Author(s):  
Basia Daria Ellis ◽  
Carly Offidani-Bertrand ◽  
Maria Joy Ferrera
Keyword(s):  
United States ◽  
Psychosocial Development ◽  
The United States ◽  
Immigrant Communities ◽  
Racially Diverse ◽  
Psychosocial Effects ◽  
Asian And Pacific Islander ◽  
Racial Ethnic ◽  
Depth Interviews

Building on recent studies of “racialized illegality,” this paper examines the psychosocial development of migrant “illegality” in a sample of ethnically and racially diverse immigrant young people. In-depth interviews and fieldnotes were collected in Chicago with White, Asian and Pacific Islander, and Latina/o immigrants ( N = 43; 14–33 years of age; 15 male, 28 female) who were undocumented and/or grew up in families with at least one undocumented parent, and who were asked to reflect on these experiences. Drawing upon the cycles of deportability framework, we theorize the psychosocial development of migrant “illegality” as a dynamic process driven by repeated, cyclical experiences with status-related stressors that regularly prompt acute fears as well as carry long-term psychosocial effects. Examining these cycles within our respondents’ reflections, we find discernible differences in both the types of status-related stressors and contexts of support experienced by Latina/o and non-Latina/o respondents, pointing to different cycles of deportability that vary along racial-ethnic lines. We maintain that these findings reflect the racialized context of migrant “illegality” in the United States, which targets primarily Latina/o migrants, as well as points to the need for increased supports for undocumented immigrants in non-Latina/o immigrant communities.

CONTENTIOUS EFFERVESCENCE: THE SUBJECTIVE EXPERIENCE OF RIOTING

2021 ◽  
Vol 26 (2) ◽  
pp. 179-196
Author(s):  
Benjamin S. Case
Keyword(s):  
United States ◽  
South Africa ◽  
Subjective Experience ◽  
The United States ◽  
Contentious Politics ◽  
Long Term Effects ◽  
Political Empowerment ◽  
Emotional Effects ◽  
Depth Interviews

How do violent protests affect social movement participants? Riots are common in civilian movements, but the effects of protester violence remain under-researched, in part due to an association of civilian protest with nonviolent methods and an association of violent protest with irrational chaos. Specifically, few studies have examined the experiences of rioters themselves. I use theoretical analysis and qualitative in-depth interviews with activists from the United States and South Africa to explore the subjective impact that moments of violent protest have on participants. Activist accounts indicate that many experience what I call “contentious effervescence,” a heightened state and sense of political empowerment amidst low-level violent actions, with long-term effects that raise consciousness and deepen and sustain activists’ resolve. I argue that examining the experiential and emotional effects of riots enhances our ability to understand contentious politics from below.

Speech-Language Pathology in the Peace Corps: Necessity and Sustainability

2012 ◽  
Vol 2 (1) ◽  
pp. 11-18
Author(s):  
Melissa A. Pierce
Keyword(s):  
United States ◽  
Special Education ◽  
Peace Corps ◽  
People With Disabilities ◽  
Communication Disorders ◽  
The United States ◽  
Speech Language Pathology ◽  
Speech Language Pathologists ◽  
Language Pathology

In countries other than the United States, the study and practice of speech-language pathology is little known or nonexistent. Recognition of professionals in the field is minimal. Speech-language pathologists in countries where speech-language pathology is a widely recognized and respected profession often seek to share their expertise in places where little support is available for individuals with communication disorders. The Peace Corps offers a unique, long-term volunteer opportunity to people with a variety of backgrounds, including speech-language pathologists. Though Peace Corps programs do not specifically focus on speech-language pathology, many are easily adapted to the profession because they support populations of people with disabilities. This article describes how the needs of local children with communication disorders are readily addressed by a Special Education Peace Corps volunteer.

Mafias on the Move

2011 ◽  
Author(s):  
Federico Varese
Keyword(s):  
United States ◽  
New York ◽  
Organized Crime ◽  
The United States ◽  
The West ◽  
Market Expansion ◽  
The North ◽  
Economic Transformations ◽  
At Will

Organized crime is spreading like a global virus as mobs take advantage of open borders to establish local franchises at will. That at least is the fear, inspired by stories of Russian mobsters in New York, Chinese triads in London, and Italian mafias throughout the West. As this book explains, the truth is more complicated. The author has spent years researching mafia groups in Italy, Russia, the United States, and China, and argues that mafiosi often find themselves abroad against their will, rather than through a strategic plan to colonize new territories. Once there, they do not always succeed in establishing themselves. The book spells out the conditions that lead to their long-term success, namely sudden market expansion that is neither exploited by local rivals nor blocked by authorities. Ultimately the inability of the state to govern economic transformations gives mafias their opportunity. In a series of matched comparisons, the book charts the attempts of the Calabrese 'Ndrangheta to move to the north of Italy, and shows how the Sicilian mafia expanded to early twentieth-century New York, but failed around the same time to find a niche in Argentina. The book explains why the Russian mafia failed to penetrate Rome but succeeded in Hungary. A pioneering chapter on China examines the challenges that triads from Taiwan and Hong Kong find in branching out to the mainland. This book is both a compelling read and a sober assessment of the risks posed by globalization and immigration for the spread of mafias.

Leaded Aviation Fuel May Present Long-Term Effects on Campus Life from the Adjacent Albert Whitted Airport

2020 ◽  
Author(s):  
Joseph Matthews ◽  
Madhu Pandey
Keyword(s):  
United States ◽  
Particulate Matter ◽  
The United States ◽  
Aviation Fuel ◽  
University Campus ◽  
Long Term Effects ◽  
Aviation Gasoline ◽  
Suspended Particulate ◽  
Descent Line

Propeller planes and small engine aircraft around the United States, legally utilize leaded aviation gasoline. The purpose of this experiment was to collect suspended particulate matter from a university campus, directly below an airport’s arriving flight path’s descent line, and to analyze lead content suspended in the air. Two collection sets of three separate samples were collected on six separate days, one set in July of 2018 and the second set in January 2019.

Markets, Technological Change and Economic Growth (The Quaid-i-Azam Lecture)

1994 ◽  
Vol 33 (4I) ◽  
pp. 327-356 ◽  
Author(s):  
Richard G. Lipsey
Keyword(s):  
United States ◽  
Economic Growth ◽  
Developing Countries ◽  
Common Ground ◽  
The United States ◽  
Industrial Countries ◽  
Canadian Institute ◽  
Primary Focus ◽  
Short Time

I am honoured to be invited to give this lecture before so distinguished an audience of development economists. For the last 21/2 years I have been director of a project financed by the Canadian Institute for Advanced Research and composed of a group of scholars from Canada, the United States, and Israel.I Our brief is to study the determinants of long term economic growth. Although our primary focus is on advanced industrial countries such as my own, some of us have come to the conclusion that there is more common ground between developed and developing countries than we might have first thought. I am, however, no expert on development economics so I must let you decide how much of what I say is applicable to economies such as your own. Today, I will discuss some of the grand themes that have arisen in my studies with our group. In the short time available, I can only allude to how these themes are rooted in our more detailed studies. In doing this, I must hasten to add that I speak for myself alone; our group has no corporate view other than the sum of our individual, and very individualistic, views.

The Future of Muslim Education in the United States: An Agenda for Research

2003 ◽  
Vol 20 (3-4) ◽  
pp. 46-82
Author(s):  
Fathi Malkawi
Keyword(s):  
United States ◽  
The United States ◽  
American Education ◽  
Future Trends ◽  
Muslim Community ◽  
Short Term ◽  
The Future ◽  
Muslim Education ◽  
Future Plans

This paper addresses some of the Muslim community’s concerns regarding its children’s education and reflects upon how education has shaped the position of other communities in American history. It argues that the future of Muslim education will be influenced directly by the present realities and future trends within American education in general, and, more importantly, by the well-calculated and informed short-term and long-term decisions and future plans taken by the Muslim community. The paper identifies some areas in which a wellestablished knowledge base is critical to making decisions, and calls for serious research to be undertaken to furnish this base.

Liberating Afghan Women

2004 ◽  
Vol 21 (3) ◽  
pp. 70-88 ◽  
Author(s):  
Nancy Gallagher
Keyword(s):  
United States ◽  
Human Rights ◽  
Historical Context ◽  
The United States ◽  
Political Organizations ◽  
Way Of Life ◽  
Afghan Women ◽  
The Media ◽  
Policy Priority

Public opinion in the United States and elsewhere celebrated the liberation of Afghan women following the defeat of the Taliban government. The United States promised to stay in Afghanistan and foster security, economic development, and human rights for all, especially women. After years of funding various anti- Soviet Mujahidin warlords, the United States had agreed to help reconstruct the country once before in 1992, when the Soviet-backed government fell, but had lost interest when the warlords began to fight among themselves. This time, however, it was going to be different. To date, however, conditions have not improved for most Afghan women and reconstruction has barely begun. How did this happen? This article explores media presentations of Afghan women and then compares them with recent reports from human rights organizations and other eyewitness accounts. It argues that the media depictions were built on earlier conceptions of Muslim societies and allowed us to adopt a romantic view that disguised or covered up the more complex historical context of Afghan history and American involvement in it. We allowed ourselves to believe that Afghans were exotic characters who were modernizing or progressing toward a western way of life, despite the temporary setback imposed by the Taliban government. In Afghanistan, however, there was a new trope: the feminist Afghan woman activist. Images of prominent Afghan women sans burqa were much favored by the mass media and American policymakers. The result, however, was not a new focus on funding feminist political organizations or making women’s rights a foreign policy priority; rather, it was an unwillingness to fulfill obligations incurred during decades of American-funded mujahidin warfare, to face the existence of deteriorating conditions for women, resumed opium cultivation, and a resurgent Taliban, or to commit to a multilateral approach that would bring in the funds and expertise needed to sustain a long-term process of reconstruction.

Asian Americans and Pacific Islanders: Employment Issues in the United States

2011 ◽  
Vol 9 (1-2) ◽  
pp. 58-69
Author(s):  
Marlene Kim
Keyword(s):  
United States ◽  
Asian Americans ◽  
The United States ◽  
Current Data ◽  
Pacific Islanders ◽  
Native Hawaiians ◽  
Data Sets ◽  
High Poverty ◽  
Unemployment Rates

Asian Americans and Pacific Islanders (AAPIs) in the United States face problems of discrimination, the glass ceiling, and very high long-term unemployment rates. As a diverse population, although some Asian Americans are more successful than average, others, like those from Southeast Asia and Native Hawaiians and Pacific Islanders (NHPIs), work in low-paying jobs and suffer from high poverty rates, high unemployment rates, and low earnings. Collecting more detailed and additional data from employers, oversampling AAPIs in current data sets, making administrative data available to researchers, providing more resources for research on AAPIs, and enforcing nondiscrimination laws and affirmative action mandates would assist this population.

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