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PubMedDate not supplied

EMS certification requirements for flight nurses.

INTRODUCTION: Emergency medical technician (EMT) or paramedic (EMTP) certification requirements for flight nurses (FNs) providing on-scene patient care vary. We surveyed those requirements and evaluated the relationships between flight team composition or program location and FN EMS certification. METHODS: Telephone survey of all 184 rotor-wing programs responding with a nurse to scenes RESULTS: The overall EMS training requirement for FNs was: none-57.6%, EMT-21.7%, EMTP-14.7%, local credential (not EMT or EMTP)-6.0%. Second team members were EMTP, RN, physician, or respiratory therapist (RRT). Overall, team configuration related significantly to FN EMS certification (P =.01). FN/EMTP and FN/RRT teams were individually significant (P <.01), with FN/EMTP teams tending not to require certification and all FN/RRT teams tending toward a certification requirement. Neither FN/FN nor FN/physician pairings related significantly with FN EMS certification requirements. Regional patterns emerged to both crew configuration and FN EMS certification requirements. CONCLUSION: Most flight programs do not require FN EMT/EMTP certification. Team configuration and geography are related to those requirements.

Air Ambulances↗
PubMed2005

Do 'food deserts' influence fruit and vegetable consumption?--A cross-sectional study.

Lack of access to affordable healthy foods has been suggested to be a contributory factor to poor diet. This study investigated associations between diet and access to supermarkets, transport, fruit and vegetable price and deprivation, in a region divergent in geography and socio-economic indices. A postal survey of 1000 addresses (response rate 42%) gathered information on family demographics, supermarket and shop use, car ownership, mobility and previous day's fruit and vegetable intake. Postcode information was used to derive road travel distance to nearest supermarket and deprivation index. Fruit and vegetable prices were assessed using a shopping basket survey. Generalised linear regression models were used to ascertain predictors of fruit and vegetable intake. Male grocery shoppers ate less fruit than female grocery shoppers. Consumption of vegetables increased slightly with age. Deprivation, supermarket fruit and vegetable price, distance to nearest supermarket and potential difficulties with grocery shopping were not significantly associated with either fruit or vegetable consumption. These data suggest that the three key elements of a food desert, fruit and vegetable price, socio-economic deprivation and a lack of locally available supermarkets, were not factors influencing fruit or vegetable intake. We suggest that food policies aimed at improving diet should be orientated towards changing socio-cultural attitudes towards food.

Cross-Sectional Studies↗
PubMed2004

[Epidemiology of infections associated to "Burkholderia cepacia complex" in the course of cystic fibrosis].

Within a few years bacteriological knowledge on Burkholderia cepacia species has progressed considerably. Within bacterial classification (taxonomy), B. cepacia gathers eight species and one species on standby of nomenclature (genomovar VI); the whole of these species constitutes the "B. cepacia complex" or B. cepacia "sensu lato" and the denomination B. cepacia "sensu stricto" is attributed to the genomovar I. These new data call into question the knowledge on the clinic and the epidemiology of B. cepacia "sensu lato" infection in the course of cystic fibrosis. Among these newly described species, B. cenocepacia (formerly genomovar III) and B. multivorans (formerly genomovar II) are the most frequent species and together they represent more than 90% of infections associated to "B. cepacia complex" in the course of cystic fibrosis. B. cenocepacia is often associated to the "cepacia syndrome" which is characterized as a fatal necrotizing pneumonia with bacteremia. The progress of molecular epidemiology allowed the description of bacterial clones of which some are highly transmissible from person-to-person. Their distribution varies according to the species and the geography. The identification of these new species appears particularly difficult and, by the fact, the data on taxonomy and molecular epidemiology can be provided only by highly specialized reference centers.

Burkholderia Infections↗
PubMed2006

Gastric cancer: global pattern of the disease and an overview of environmental risk factors.

This first part of this chapter looks at the worldwide burden of gastric cancer at the beginning of the 21st century and summarises available population-based routine data that describes the variation in incidence of the disease in relation to age, sex, geography and time period. Consideration is also given to the differences in the descriptive epidemiology of gastric cancer arising in the proximal cardia region of the stomach. In the second part of the chapter, a brief review of the main identified environmental risk factors is conducted drawing, where available, on published systematic literature overviews and meta-analyses. Evidence relating the aetiology of gastric cancer to Helicobacter pylori infection, dietary factors, smoking, occupation, physical activity and anthropometry is presented.

Environmental Exposure↗
PubMed2005

Added cognitive load through rotary auditory stimulation can improve the quality of postural control in the elderly.

This study examined the effect of rotary auditory stimulation on postural control in the elderly. Thirty-two subjects aged over sixty were submitted to two rotary auditory stimulations, with a meaningful and a non-meaningful message, during a postural task. Although the non-meaningful task did not lead to postural control modification, the meaningful task allowed a reduction in the postural parameter values and therefore, a better stabilisation of posture. The attention, paid to the geography of the sound in understanding the story being told, forced the subject into taking into consideration the regularity and rotation of the stimulation, which meant relying on an auditory anchorage and so facilitated posture regulation.

Acoustic Stimulation↗
PubMed2007

Fostering ecologic perspectives in child psychiatry.

In this article, the authors seek to instill a readiness and enthusiasm for appreciating the many-faceted influences in the lives and struggles of developing children and their families. A framework for clinical investigation is proposed that draws from ecologic, ethnographic and attributional perspectives and therein augments and extends contemporary notions of culturally competent care. This framework can be used to help illuminate the culturally-relevant geography of the child's world such as: 1) health care and social welfare zones, 2) child activity zones, and 3) cultural and religious spheres of influence. Training tools and strategies are offered for building insightful, respectful and convivial co-investigator partnerships with patients and their families.

Adolescent↗
PubMed2004

Impact of fermented brown rice with Aspergillus oryzae (FEBRA) intake and concentrations of polybrominated diphenylethers (PBDEs) in blood of humans from Japan.

The isotope dilution technique was applied for the analysis of new polybrominated diphenylethers (PBDEs) calibration standard (both labeled and non-labeled) using high-resolution gas chromatography-high-resolution mass spectrometry (HRGC-HRMS). The relative response factor (RRF) and relative standard deviation (RSD) for new calibration standard in Finnigan Thermo Electron (MAT-95XL) and Micromass (Autospec Ultima) were more or less identical with mean RRF (0.9882), RSD (0.0865) and CV% of (8.75). The results also revealed for DeBDE-209 quantification; labeled DeBDE-209 is essential. Furthermore, we recommend on column injection technique with a thin film instead of splitless injection in order to reduce the thermal degradation of DeBDE-209 and formation of octabromodibenzofurans (OBDF). Besides, analysis of human blood (n = 156) of FEBRA-intake and non-FEBRA-intake individuals elucidated frequent detection of eighteen PBDE congeners. The average PBDE concentrations in non-FEBRA intake and FEBRA-intake humans were 6000-11,000 (mean: 8400) and 5400-15,000 (mean: 9900) respectively on pg/g fat basis. Although FEBRA-intake individuals showed slightly greater PBDEs, computer-normalized concentrations of TeBDE-47 corroborate FEBRA-intake individual from four family showed reduced concentrations. The contamination profiles of PBDEs varied in between family, gender as well as geography. International comparison with predominant PBDE congener (TeBDE-47) prevailed lower levels in Japan when compared to Korea, Germany and USA nevertheless, congener specific profiles were different which is in accordance with different technical PBDE usage in between countries.

Adult↗
PubMed2005

Persistent organic pollutant patterns in grey seals (Halichoerus grypus).

The aim of this paper is to examine the patterns of polychlorinated biphenyls (PCB) in the grey seals (Halichoerus grypus) from the Baltic, Northeast and Eastern England, and the St. Lawrence Estuary (Canada). In fact, the feeding habits of the ringed seal (Phoca hispida) include ingestion of major quantities of benthic crustaceans that might cause observed differences obtained in PCBs, whereas the grey seal feed mainly on fish. The profile (percent in mixture) of polychlorinated biphenyls (PCB) 101, 118, 138, 153, and 180, and the total of their concentrations in mg/kg lipid in grey seals from the Baltic, from Northeast and Eastern England, and from the St. Lawrence estuary (Canada), were examined by principal component analysis (PCA). When considering the possible effects of consuming seafood by the grey seal, it is necessary to characterize populations and individuals according to the amounts they consume, since populations in different parts of the world are likely to show big differences in their consumption of seafood. The patterns differ between juveniles and adult animals, but the gender of adults and geography do not appear to play a role.

Adipose Tissue↗
PubMed2006

The influence of surface-active media on the mechanical properties of materials.

This survey summarizes studies dealing with the influence of surface-active media on the mechanical behavior of materials that have been carried out at the Institute of Physical Chemistry of the Russian Academy of Sciences, at the Department of Chemistry of Moscow State University and at the Department of Geography and Environmental Engineering of the Johns Hopkins University, and presented partially at the SIS Symposia. The phenomena of the environment-sensitive mechanical behavior take place for all kinds of solids under the effect of adsorption layers and due to the contact with liquid phases containing some specific components which are physically-chemically akin with respect to a given solid and cause lowering of the surface energy of the solid and weakening of the cohesive forces in the surface (interfacial) layer. Studies of these effects and their atomic-molecular mechanisms provide basis for control, prevention or utilization of these phenomena.

Journal Article↗
PubMed2006

Molecular diagnostics of genetic eye diseases.

Eye diseases can be simple or complex, and mostly of heterogeneous molecular genetics. Some eye diseases are caused by mutations in a single gene, but some diseases, such as primary open angle glaucoma, can be due to sequence variations in multiple genes. In some diseases, both genetic and epigenetic mechanisms are involved, as was recently revealed in the mechanism of retinoblastoma. Disease causative mutations and phenotypes may vary by ethnicity and geography. To date, more than a hundred candidate genes for eye diseases are known, although less than 20 have definite disease-causing mutations. The three common genetic eye diseases, primary open angle glaucoma, age-related macular degeneration, and retinitis pigmentosa, all have known gene mutations, but these account for only a portion of the patients. While the search for eye disease genes and mutations still goes on, known mutations have been utilized for diagnosis. Genetic markers for pre-symptomatic and pre-natal diagnosis are available for specific diseases such as primary open angle glaucoma and retinoblastoma. This paper reviews the molecular basis of common genetic eye diseases and the available genetic markers for clinical diagnosis. Difficulties and challenges in molecular investigation of some eye diseases are discussed. Establishment of ethnic-specific disease databases that contain both clinical and genetic information for identification of genetic markers with diagnostic, prognostic, or pharmacological value is strongly advocated.

Eye Diseases, Hereditary↗
PubMed2006

Epidemiology of work-related upper extremity disorders: understanding prevalence and outcomes to impact provider performances using a practice management reporting tool.

In 2001, the number of repeated trauma cases accounted for 4% of total workplace injuries and 65% of all occupational illnesses, with work-related upper extremity disorders accounting for most cases. Because chronic disability leads to the highest cost, systematic evaluation of this growing occupational condition is needed. This article sheds light on work-related upper extremity disorders by understanding the prevalence and pattern for these diagnoses, their impact on outcomes influenced by age, gender and geography on metrics such as utilization, duration, disability status, and costs. To assess these types of outcomes measurements, a good reporting and management system must be in place to allow for ongoing evaluation and analysis of data and in the construction of intervention programs to improve provider performances and, ultimately, patient outcomes.

Adult↗
PubMed2005

CAM in Canada: places, practices, research.

This paper reflects on the practice and research of complementary and alternative medicine (CAM) in Canada. Although certain trends in use, as well as the regulation and integration of CAM, are mirrored in many other developed countries, some are highlighted as uniquely Canadian with distinct political and economic geographies. Similarly, although like in other countries the research of CAM is growing rapidly, Canadian scholars have been particularly productive in terms of providing unique disciplinary perspectives and the ways in which they have organized their research training and collaborations. CAM is clearly not a fully integrated and researched option in Canadian health care, yet Canada exhibits the foundations for an integrated CAM practice, supported by a growing, wide-ranging and well-articulated research evidence-base.

Canada↗
PubMed2026

Viral community structure in New Zealand's aquatic birds is associated with scavenging behavior.

Wild migratory birds play a major role in the global spread of viruses, yet the ecological drivers underpinning viral diversity and transmission, particularly host behavior, remain poorly understood. Aotearoa/New Zealand provides a powerful system to address this, including unique species that reflect its geographical isolation, yet with international connections provided by migratory birds across the East Asian-Australasian Flyway and Antarctic regions. Herein, we conducted a large-scale metatranscriptomic survey of wild birds across New Zealand and its subantarctic islands, in which we collected 1,348 samples from 690 individuals across 31 host species spanning four avian orders. We identified 118 avian viruses from 17 families, including 107 novel species, expanding our knowledge of avian viral diversity. Notably, viral community composition was most strongly associated with bird scavenging behavior, which explained more variation than host taxonomy, geography, or migratory status. Scavenging birds and opportunistic scavengers harbored more diverse viromes than non-scavengers, consistent with increased viral exposure across trophic levels. This was supported by the detection of 12 mammalian-associated viruses, primarily in scavengers, including hedgehog hepatovirus, rabbit hemorrhagic disease virus 2, and sea lion astroviruses, with host sequence data confirming dietary origin. We also detected viruses of epidemiological and evolutionary interest, including a low-pathogenic avian influenza A(H1N9) virus from red knots (Calidris canutus) and a divergent tobanivirus from Auckland Island teal (Anas aucklandica), which represented the first putative avian member of the Tobaniviridae. These findings suggest that virome structure in wild birds is associated with scavenging behavior, thus highlighting the importance of incorporating host ecology into viral surveillance and risk assessment.

New Zealand↗
PubMed2006

Civilising missions, natural history and British industry: Livingstone in the Zambezi.

High hopes for opening new markets, locating natural resources and the 'advance of civilisation' were built into the plans for Victorian expeditions to Africa. When an expedition failed to deliver on these goals, criticisms of individual explorers and the entire 'civilising mission' project could result. The Zambesi Expedition, led by David Livingstone, received just such criticism when politics and geography obstructed the realisation of its aims. The needs of a growing industrial sector contributed to the organisation of the Expedition but also set the criteria by which its success or failure would be judged.

Africa↗
PubMed2005

Some mathematical problems in the DNA identification of victims in the 2004 tsunami and similar mass fatalities.

DNA is a major and essential identification tool for mass fatality incidents including the hundreds of thousands of victims of the 2004 Indian Ocean tsunami. Mathematical complications characteristic of this sort of mass fatality include prevalence of related victims, the many races represented among the victims, and various identification modalities in tandem with DNA. Four mathematical problems of interest are discussed in this paper. (1) Other quantifiable factors (i.e. geography) can be formally accounted for by including a likelihood ratio that can be thought of as reducing the "effective number of victims." (2) When a victim is found and tentatively identified as V, but then it comes to light that the victim has a relative W who is also missing, confidence in the identity is depressed. To account for the existence of W, increment the effective number of victims by the likelihood ratio supporting W as the identity of the victim. (3) When several apparently related victims are found, their mutual identities should be calculated simultaneously. Compared to one-at-a-time, serial identifications, this is both logical and may lead to much more confidence in the identities. (4) Although there may be many different population groups represented among the missing, it is generally sufficient to consider population statistics for only a few of them in deciding whether to declare an identification.

DNA↗
PubMed2025

Global considerations for lifelong management and therapeutic development for phenylketonuria.

Phenylketonuria (PKU) is an inherited metabolic disorder characterized by the accumulation of toxic phenylalanine levels in the brain that can lead to neurocognitive impairment if untreated. This review evaluates unmet needs in PKU, the importance of newborn screening (NBS), and considerations for chronic treatment options. An international group of experts reviewed the available literature across ethnicities and geographies to identify unmet needs of individuals with PKU. Treatment was assessed in a global context to address patient benefit. Reflecting challenges to the worldwide PKU community, some countries have been unable to implement NBS programs and/or do not apply a treatment-for-life approach. Ongoing challenges for individuals with PKU include maintaining adherence to treatment guidelines for patient- and practice-specific reasons, such as inadequate access to low-cost treatment, insufficient social support, limited clinical staffing, and disease burden. Dietary interventions may not adequately address all symptoms, and some of the current pharmacotherapies may be associated with limited efficacy or adverse events. Several new therapies are being evaluated for the treatment of PKU, offering the potential to address unmet needs. Global availability of NBS programs, access to treatments, and a tenacious commitment to treatment-for-life are expected to improve outcomes for individuals with PKU across geographic regions.

Humans↗
PubMed2004

Physician accessibility: an urban case study of pediatric providers.

Social disparity in the spatial distribution of healthcare providers in urban areas is a recognized problem. However, efforts to quantify the problem have been hampered by a lack of satisfactory measurements and methods. We revive and enhance a strategy based on provider density, proposed nearly three decades ago. The method avoids the border-crossing problem associated with provider-population ratios, yet reports spatial accessibility in intuitive units that are easily compared across diverse populations and geographies. We find racial and socioeconomic disparities in our case city, Washington, DC, despite a citywide overabundance of primary care providers for children.

Child↗
PubMed2005

The place of motorsport in public health: an Australian perspective.

The sport of motor racing provides various public health messages and impacts. Positive messages include road safety campaigns aimed at discouraging drink driving. Negative messages include the sponsorship of racing teams by cigarette companies. Locating motorsport events in significant public places can magnify any health messages or impacts of motorsport in two ways. First, the total local impact of the motor racing events (e.g. through pollution or disruption to healthy modes of transport) is greater in city street circuits than in dedicated racing circuits away from urban areas. Second, the symbolic characteristics of locations with special significance and meaning can enhance the impacts on health by adding legitimacy to the events, thus helping to promote products or activities that either undermine or support public health. This paper explores the health messages and impacts of major motorsport events in Australia, and argues that the distinctive geographies of Australian motorsport work to exacerbate the negative impacts of motorsport on public health.

Australia↗