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At least 199 records · Page 11Linked to original sources
PubMed2002

Blunt and penetrating injuries caused by rubber bullets during the Israeli-Arab conflict in October, 2000: a retrospective study.

BACKGROUND: Low-velocity rubber bullets were used by Israeli police to control riots by Israeli-Arabs in early October, 2000. We aimed to establish the factors that contribute to severity of blunt and penetrating injuries caused by these missiles. METHODS: We analysed medical records of 595 casualties admitted. We assessed relation of severity of injury to type of bullet, anatomical region of injury, and final outcome. Severity of injury was established by the abbreviated injury scale, and we calculated injury severity score. FINDINGS: 151 males and one female (age range 11-59 years) were included in the study, in whom 201 proven injuries by rubber bullets were detected. Injuries were distributed randomly over the body surface and were mostly located in the limbs (n=73), but those to the head, neck, and face (61), chest (39), back (16), and abdomen (12) were also frequently noted. 93 (61%) patients had blunt injuries and 59 (39%) penetrating ones. Severity of injury was dependent on ballistic features of the bullet, firing range, and anatomic site of impact. Two casualties died after a penetrating ocular injury into the brain and one died as a result of postoperative aspiration after a knee injury. INTERPRETATION: Resistance of the body surface at the site of impact (elastic limit) is the important factor that ascertains whether a blunt or penetrating injury is inflicted and its severity. Inaccuracy of rubber bullets and improper aiming and range of use resulted in severe injury and death in a substantial number of people. This ammunition should therefore not be considered a safe method of crowd control.

Adolescent↗
PubMed2006

[Assessing program sustainability in public health organizations: a tool-kit application in Haiti].

BACKGROUND: Public health stakeholders are concerned about program sustainability. However, they usually conceive sustainability in accordance with financial criteria for at least one reason. No simple frameworks are operationally and theoretically sound enough to globally evaluate program sustainability. The present paper aims to describe an application of one framework assessment tool used to evaluate the sustainability level and process of a Nutritional Care Unit managed by a Swiss humanitarian agency to fight against severe child malnutrition in a Haitian area. The managing agency is committed to put this Unit back into the structure of a local public hospital. METHODS: The evaluation was performed within the sustainability framework proposed in a former article. Data were collected with a combination of tools, semi-structured interviews (n=33, medical and support staff from the agency and the hospital), participatory observation and document review. Data concerned the four characteristics of organizational routines (memory, adaptation, values and rules) enabling assess to the level of sustainability. In addition, data were related to three types of events distinguishing routinization processes from implementation processes: specific events of routinization, routinization-implementation joint events, and specific events of implementation. Data analysis was thematic and results were validated by actors through a feed-back session and written comments. RESULTS: The current level of sustainability of the Nutritional Care Unit within the Hospital is weak: weak memory, high adaptation, weak sharing of values and rules. This may be explained by the sustainability process, and the absence of specific routinization events. The relevance of such processes is reasonable, while it has been strongly challenged in the troublesome Haitian context. Riots have been widespread over the last years, creating difficulties for the Hospital. CONCLUSION: This experience suggests the proposed framework and sustainability assessment tools are useful when the context permits scrutinization of program sustainability.

Child↗
PubMedDate not supplied

Natural hazards: causes and effects. Lesson 5--Tropical cyclones (hurricanes, typhoons, baguios, cordonazos, tainos).

The many conclusions drawn and lessons learned from past cyclones can be used to mitigate and better respond to future occurrences. Some of the most helpful are listed below: 1) Outbreaks of cholera do not follow cyclones. Cholera must be endemic previously to a community; 2) Waterborne diseases do not increase as a result of cyclones; 3) Massive food aid rarely is required after a cyclone; 4) Used clothing almost never is needed. It usually is culturally inappropriate. Though accepted by disaster victims, it almost never is worn; 5) Blankets can be useful, but if they are needed, they usually can be found locally and do not need to be imported; 6) Assistance by outsiders is most effective in the reconstruction period, not the emergency phase; 7) Most needs are met by the victims themselves or their local governments; 8) In general, victims do not respond to disasters with abnormal behavior. Cyclones do not incite panic, hysteria, or rioting; 9) Cyclone relief and reconstruction programs should be integrated with long-term development programs; 10) When properly executed, reconstruction assistance can provide a strong stimulus to recovery and a base for future development work; 11) Reconstruction programs should seek to reduce vulnerability to future disaster; 12) Re-establishment of the local economy, income security, and agriculture usually are more important to cyclone victims than is material assistance; and 13) Churches, schools, and other large buildings that often are designated as cyclone shelters usually are not safe. The number of deaths attributed to destroyed or flooded shelters is alarming. Most experts agree that the best alternative is adequate warning and evacuation of the threatened areas.

Disaster Planning↗
PubMed2006

Direct sampling of chemical weapons in water by photoionization mass spectrometry.

The vulnerability of water supplies to toxic contamination calls for fast and effective means for screening water samples for multiple threats. We describe the use of photoionization (PI) mass spectrometry (MS) for high-speed, high-throughput screening and molecular identification of chemical weapons (CW) threats and other hazardous compounds. The screening technology can detect a wide range of compounds at subacute concentrations with no sample preparation and a sampling cycle time of approximately 45 s. The technology was tested with CW agents VX, GA, GB, GD, GF, HD, HN1, and HN3, in addition to riot agents and precursors. All are sensitively detected and give simple PI mass spectra dominated by the parent ion. The target application of the PI MS method is as a routine, real-time early warning system for CW agents and other hazardous compounds in air and in water. In this work, we also present comprehensive measurements for water analysis and report on the system detection limits, linearity, quantitation accuracy, and false positive (FP) and false negative rates for concentrations at subacute levels. The latter data are presented in the form of receiver operating characteristic curves of the form of detection probability P(D) versus FP probability P(FP). These measurements were made using the CW surrogate compounds, DMMP, DEMP, DEEP, and DIMP. Method detection limits (3sigma) obtained using a capillary injection method yielded 1, 6, 3, and 2 ng/mL, respectively. These results were obtained using 1-microL injections of water samples without any preparation, corresponding to mass detection limits of 1, 6, 3, and 2 pg, respectively. The linear range was about 3-4 decades and the dynamic range about 4-5 decades. The relative standard deviations were generally <10% at CW subacute concentrations levels.

Chemical Warfare Agents↗
PubMed2006

Fate of chemical warfare agents and toxic industrial chemicals in landfills.

One component of preparedness for a chemical attack is planning for the disposal of contaminated debris. To assess the feasibility of contaminated debris disposal in municipal solid waste (MSW) landfills, the fate of selected chemical warfare agents (CWAs) and toxic industrial chemicals (TICs) in MSW landfills was predicted with a mathematical model. Five blister agents [sulfur mustard (HD), nitrogen mustard (HN-2), lewisite (L), ethyldichloroarsine (ED), and phosgene oxime (CX)], eight nerve agents [tabun (GA), sarin (GB), soman (GD), GE, GF, VX, VG, and VM], one riot-control agent [CS], and two TICs [furan and carbon disulfide] were studied. The effects of both infiltration (climate) and contaminant biodegradability on fate predictions were assessed. Model results showed that hydrolysis and gas-phase advection were the principal fate pathways for CWAs and TICs, respectively. Apart from CX and the TICs, none of the investigated compounds was predicted to persist in a landfill for more than 5 years. Climate had little impact on CWA/TIC fate, and biodegradability was only important for compounds with long hydrolysis half-lives. Monte Carlo simulations were performed to assess the influence of uncertainty in model input parameters on CWA/TIC fate predictions. Correlation analyses showed that uncertainty in hydrolysis rate constants was the primary contributor to variance of CWA fate predictions, while uncertainty in the Henry's Law constant and landfill gas-production rate accounted for most of the variance of TIC fate predictions. CWA hydrolysates were more persistent than the parent CWAs, but limited information is available on abiotic or biotic transformation rates for these chemicals.

Biodegradation, Environmental↗
PubMed2001

Severe cutaneous reaction to CS gas.

Tear gas is used throughout the World for control of riots and civil disobedience. CS gas as used by the UK police force is issued as a 'spray' and is 5% CS in methylisobutylketone (MIBK), a potent irritant. Assaults on police officers in forces issued with CS spray have fallen significantly over the past 3 years, whilst having risen in areas without it. Thus, CS gas appears to be an effective deterrent. However, significant cutaneous reactions can occur as a result of exposure. We report a severe contact dermatitis to CS gas to highlight the clinical features. The nature of CS gas and potential cutaneous adverse reactions are discussed.

Adult↗
PubMed1999

Absconding: outcome and risk.

Absconding by patients from acute psychiatric wards is known to be linked to self harm and harm to others. Previous research has focused only on officially reported absconds, thus missing out many patients who although they abscond and pose a risk, are never officially processed. This paper reports the findings of a large prospective study of absconding in the East End of London using an objective definition of absconding not linked to official bureaucratic processes. Absconders are considered by staff to be high risk patients, and many have histories of violence and/or suicide attempts. Nevertheless nurses only request the aid of the police in returning patients on 47% of occasions. The actions of the police are very variable, and range from two policemen calling at the patient's house, to an entire team in riot gear appearing at the patient's door in the early hours of the morning. Most absconds result in no harm to anyone, and most absconders return by themselves. Relatives and carers also play a significant role in persuading the patient to return or bringing them back. Nurses should develop more sophisticated ways of working with the police and with relatives to maintain absconding patients' safety.

Escape Reaction↗
PubMed1982

The emergency evacuation of a geriatrics hospital in Toxteth.

The evacuation of a 102-bed geriatrics hospital in the middle of the night and from the centre of a riot in Toxteth, Liverpool, is described, together with its effect on the patients involved. No increase in the mortality rate occurred during the six weeks following the evacuation, but a significant increase in morbidity was found. Specific recommendations are made for action to be taken should other city centre geriatrics hospitals need to be evacuated in similar circumstances.

Aged↗
PubMed1991

Analysis of the aneuploidy inducing capacity of 2-chlorobenzylidene malonitrile (CS) and metabolites in V79 Chinese hamster cells.

The aneuploidy inducing capacity of 2-chlorobenzylidene malonitrile (CS), a chemical used as a riot control agent, and its hydrolysis products o-chlorobenzaldehyde and malonitrile was studied at various exposure conditions in V79 Chinese hamster cells. Chromosomes were counted in metaphase preparations with preserved cytoplasm. A significant increase in the number of aneuploid cells was found after CS and o-chlorobenzaldehyde exposure but not after malonitrile exposure. o-chlorobenzaldehyde, which also introduced high levels of polyploid cells, seems to be an important metabolite for the aneuploidogenic effectiveness of CS.

Aneuploidy↗
PubMed1997

Sociopolitical antecedents to Stonewall: analysis of the origins of the gay rights movement in the United States.

The 1969 Stonewall riot in New York City is widely celebrated as the beginning of the modern gay rights movement. However, the social changes that followed were possible only because of a decades-long indigenous organization. This article examines three traditional organizational theories on social action movements and applies Aldon Morris's analytical framework for understanding collective social action to the emergence of the modern U.S. gay civil rights movement. The author concludes that social workers need to understand how to gain access to and support indigenous social structures to assist oppressed groups to bring about social change.

Civil Disorders↗
PubMed1998

Injury patterns in a plastic (AR-1) baton fatality.

Rubber and plastic bullets or batons have been used in countries outside the United States for several years. These devices were designed to inflict nonlethal force in riot control. The authors report a case of fatal injury sustained by an elderly woman struck in the chest by a plastic baton, including the circumstances surrounding this unusual incident, the autopsy findings and a review of the literature.

Fatal Outcome↗
PubMed2004

Glow curve evaluation in routine personal dosimetry.

The glow curve of LiF:Mg, Ti (TLD-100) has a well known and defined shape. Several factors, however, can distort the glow curve shape and can lead to incorrect dosimetry. Only proper evaluation of glow curves, either by visual inspection or computerized method, can detect these anomalies. Visual observation is riot only tedious and time consuming but may also be susceptible to human errors. The usefulness of a commercially available glow curve analysis software during quality control testing of thermoluminescence dosimetry cards is discussed. The long-term stability of the thermoluminescence dosimetry reader is also investigated using this software. Various types of glow curve anomalies encountered during routine personal dosimetry practice are presented.

Algorithms↗
PubMed2000

Challenges of toxicology for the millennium.

In meeting the challenges of toxicology, clinical and forensic toxicologists should expand their services and engage in research and development to meet changing needs. Expanding roles could potentially derive from the threat of terrorism, genotyping for interpretation of potential toxic drug interactions, and criminalistic testings. At the threshold of the next millennium, terrorism via weapons of mass destruction (WMD) has migrated from the war zones to civilian settings. These WMD may be in the form of nuclear, biological, and chemical devices (NBC). Recently, the possible use of chemical/biological weapons in the Middle East conflicts, the use of sarin in a Tokyo subway station, and the unregulated availability of nuclear fuel in some countries all have heightened the potential for international and domestic NBC. In preparation for NBC, both government and civilians in major American cities have been trained for safe handling of patients and casualties. Forensic and clinical toxicologists should be knowledgeable about the clinical pharmacology, safe samples processing, and possible screening and/or analysis of samples exposed to or containing: vesicants; cyanide; and nerve, riot control, and pulmonary agents. These samples may be transported for further analysis and confirmed by designated central laboratories. In criminal/correctional settings, toxicologists should engage in quality assurance and consultation with attorneys, judges, and correctional professionals. With the emergence of pharmacogenetics, genotyping may enhance rational drug therapy for enhanced patient care, and may explain adverse or fatal drug reactions in postmortem analysis.

Animals↗
PubMed1987

Gunshot wounds and stabbings: experience with 124 cases.

A retrospective study was undertaken of 124 patients admitted with gunshot and stab wounds between January 1980 and the end of June 1985. The present series found an almost equal number of gunshot wounds (65) and stabbings (59), with an increasing incidence. The patients fell heavily into the categories of being male (88.7%), in their twenties (42%) and having consumed alcohol (52% when documented). There were 77 cases of assault, with 50 of these being caused by persons known to the victim, whilst violent crimes and prison riots accounted for the rest. The majority of injuries occurred outside normal working hours, with 62% arriving at the hospital between 8 pm and 8 am. There were 14 deaths (11.3%), usually within the first 4 h, with all but one occurring in the first 24 h. Gunshot wounds resulted in a higher mortality rate (16.9% cf. 5%) and longer hospital stay.

Adolescent↗
PubMed1999

Concert medicine: spectrum of medical problems encountered at 405 major concerts.

OBJECTIVES: To identify factors predictive of patient load at major commercial concert first-aid stations, and to characterize the spectrum of presenting injuries and illnesses at such events. METHODS: This study was a retrospective case series of patients presenting to on-site first-aid stations at five major concert venues in southern California over a five-year period. The authors compared the number of patients per ten thousand attendees (PPTT) with four potential predictors (music type, overall attendance, temperature, and indoor vs outdoor location) using univariate techniques and negative binomial regression. The spectrum of chief complaints observed is described. RESULTS: There were 1,492 total patients out of 4,638,099 total attendees at 405 separate concerts. The median patient load per concert was 2.1 PPTT, ranging from 0 PPTT at 53 concerts to 71 PPTT at a punk rock festival that turned into a riot. Patient load varied significantly by music category (p = 0.0001) but not with overall attendance, temperature, or indoor vs outdoor location. Median PPTT by music category ranged from 1.3 PPTT for rhythm and blues to 12.6 PPTT for gospel/Christian, with negative binomial regression indicating that rock concerts had 2.5 times (95% CI = 2.0 to 3.0) the overall patient load of non-rock concerts. Music type, however, was able to account for only 4% of the variability observed in the regression model. Trauma-related complaints predominated overall, with similar rates at rock and non-rock concerts. Four cardiac arrests occurred at classical concerts. CONCLUSION: Rock concert first-aid stations evaluated 2.5 times the patient load of non-rock concerts overall, although there was substantial concert-to-concert variability. Trauma-related complaints predominate at both rock and non-rock events. These data may assist individuals and organizations planning support for such events.

Adolescent↗
PubMed1988

Psychiatric and social problems among immigrants.

High rates of mental morbidity among migrants are common but not universal. Differences in rates may reflect factors in: (a) the country of origin; (b) the actual move; (c) the country of settlement. About 1.8 million people came to Britain in 1950-1970 from the West Indies and Indian subcontinent. They resembled Gastarbeiters in other European countries, except that as Commonwealth citizens they had the right of permanent residence. With their children (many of whom are now adults) they are 3.5% of Britain's population. Britain does not have a liberal cosmopolitan culture in which newcomers are welcomed, and the situation has deteriorated in response to high unemployment, constrained public expenditure, and widening gulfs between income-groups. Minority groups are scapegoated, and racial prejudice is more apparent than ever. Black people face obstacles in education and employment. Immigration laws which curtail the right to live in Britain have created insecurity, which is aggravated by insensitive policing and irresponsible press reporting. Institutions and authorities have been slow to respond to the different needs of new cultures. Riots receive more publicity than the daily violence which black people experience, which includes implicit contempt expressed as negative stereotypes, and explicit physical harassment. In this situation a high incidence of stress-related disporders might be predicted. There has been insufficient community-based research but one study of Indian and Pakistani samples showed them to have less mental and emotional disorder than indigenous controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Acculturation↗
PubMed1974

The response of laryngeal afferent fibres to mechanical and chemical stimuli.

1. We have recorded afferent activity from ;single fibres' dissected from the superior laryngeal nerve of anaesthetized cats.2. Units which responded to gentle mechanical stimulation of the larynx epithelium were chosen for study.3. Receptors with myelinated fibres were grouped according to their spontaneous activity. Group 1 fibres had little or no spontaneous activity: group 2 fibres had constant and continuous spontaneous activity.4. Group 1 fibres had a wide range of adaptation rates. Their conduction velocities lay between 3.0 and 30 m/sec. The receptors were generally stimulated by ammonia and distilled water and often by CS riot control agent, 5 and 10% CO(2), 200 ppm SO(2), and cigarette smoke. Histamine, phenyl diguanide, graphite dust, 100 ppm SO(2) and saline drops did not generally excite the fibres.5. Group 2 fibres were slowly adapting. Their conduction velocities ranged between 8.0 and 26.5 m/sec. Ammonia usually, and distilled water sometimes, excited these fibres while 5 and 10% CO(2) mixtures inhibited them. A minority of group 2 fibres were pH sensitive, inhibited by acids and stimulated by alkaline buffers. Cigarette smoke had complex actions, either excitation, inhibition or, at different times, both. Histamine, P.d.g., CS, SO(2), saline drops and dust had no action on these fibres.6. Recordings were made from one unmyelinated fibre (conduction velocity 1.9 m/sec) which responded to stroking of the epithelium with a thread and to histamine, P.d.g. and ammonia vapour applied to the epithelium.7. We consider the site, method of excitation and reflex actions of the different receptors described.

Action Potentials↗
PubMed2000

Infectious diseases. Has leishmaniasis become endemic in the U.S.?

Believed to be all but absent from United States, the Leishmania parasite has infected more than 1000 hunting dogs in 21 U.S. states and the Canadian province of Ontario. Nobody is claiming that the disease is about to run riot among the U.S. population. But the widespread outbreak in dogs has experts wondering whether visceral leishmaniasis--which sickens over half a million people yearly in South America, Africa, the Mediterranean, and India--has become an endemic disease in North America.

Animals↗