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On September 20, 2017, Hurricane Maria made landfall on Puerto Rico as a category 4 storm, resulting in serious widespread impact across the island, including communication and power outages, water systems impairment, and damage to life-saving infrastructure. In collaboration with the Puerto Rico Department of Health, the Public Health Branch (PHB), operating under the Department of Health and Human Services Incident Response Coordination Team, was tasked with completing assessments of health-care facilities in Puerto Rico to determine infrastructure capabilities and post-hurricane capacity. Additionally, in response to significant data entry and presentation needs, the PHB leadership worked with the Puerto Rico Planning Board to develop and test a new app-based infrastructure capacity assessment tool. Assessments of hospitals were initiated September 28, 2017, and completed November 10, 2017 (n = 64 hospitals, 97%). Assessments of health-care centers were initiated on October 7, 2017, with 186 health-care centers (87%) assessed through November 18, 2017. All hospitals had working communications; however, 9% (n = 17) of health-care centers reported no communication capabilities. For the health-care centers, 114 (61%) reported they were operational but had sustainment needs. In conclusion, health-care facility assessments indicated structural damage issues and operational capacity decreases, while health-care centers reported loss of communication capabilities post-Hurricane Maria.
Declining species richness is a global concern; however, the coarse-scale metrics used at regional or landscape levels might not accurately represent the important habitat characteristics needed to estimate species richness. Currently, there exists a lack of knowledge with regard to the spatial extent necessary to correlate remotely sensed habitat metrics to species richness and animal surveys. We provide a protocol for determining the best scale to use when merging remotely sensed habitat and animal survey data as a step towards improving estimates of vertebrate species richness on broad scales. We test the relative importance of fine-resolution habitat heterogeneity and productivity metrics at multiple spatial scales as predictors of species richness for birds, frogs and mammals using a Bayesian approach and a combination of passive monitoring technologies. Model performance was different for each taxonomic group and dependent on the scale at which habitat heterogeneity and productivity were measured. Optimal scales included a 20-m radius for bats and frogs, an 80-m radius for birds and a 180-m radius for terrestrial mammals. Our results indicate that optimal scales do exist when merging remotely sensed habitat measures with ground-based surveys, but they differ between vertebrate groups. Additionally, the selection of a measurement scale is highly influential to our understanding of the relationships between species richness and habitat characteristics.
On the afternoon of July 25, 1927, a young shepherdess set fire to a hillside on Florentino Serrudo’s estate, launching the greatest insurrection of indigenous peasants since the Federal War of 1899 – and the first in Bolivia to be labeled “communist.” This chapter takes seriously the fears that the Chayanta (Bolivia) rebellion of 1927 generated among landlords, state officials, and the press, and examines the dynamics of mobilization, the formation of alliances among indigenous caciques, artisans, and intellectuals, and the state response. It shows that in the years before the Chayanta uprising, rural caciques from indigenous communities and radical artisans and intellectuals in the cities of Sucre and Potosí formed a political alliance based on a shared commitment to rural education, communal land ownership, and redistribution of wealth and power. This incipient alliance sought to erase ethnic and class hierarchies in order to build a more democratic society, and largely succeeded in blocking further landlord advance in the southern Bolivian countryside.
It is difficult to imagine a more defiantly quixotic and historically bellicose people than those who inhabit Canhabac Island in the Bijagos Archipelago, just off the southerly coast of Guinea-Bissau. Since the settlement of the archipelago in the thirteenth to the fourteenth centuries, the indigenous people of Canhabac, called Canhabacers or the Bijagos of Canhabac, have proven their skill not only as fishermen, builders of seafaring canoes, agriculturalists, barter merchants, artisanal craftsmen, and spiritualists, but also as coastal slave raiders, slave traders, international commercialists, and capable of a fierce and effective defense of their islands against a lengthy historical train of would-be invaders. The Portuguese waged repeated wars against Canhabacers, usually to be repeatedly turned back or worn down; French and British warships had several military encounters with Canhabac war canoes on the high seas, mostly ending badly for the Europeans. Enthusiastic to develop economic exchange relations with coastal peoples— and with European settlers—and happy to join a network of global trade relations throughout their storied history, Canhabac islanders also have made clear, over the centuries, their determination to retain political autonomy over their habitat.
In this study, these themes are pursued in order to make clear the unusual ways in which the Bijagos of Canhabac have asserted themselves in the past several centuries both defensively as well as in pursuing offensive military operations; actively engaging in global commercial relations while at the same time painstakingly recreating a self-sustaining economic ne oautarchy. Social relations were characterized by an enduring villagecentered authority system in which decision-making roles were remarkably gender balanced. More generally, I indicate that Canhabacers were geographically sufficiently isolated from mainland Guinea-Bissauan societies to have maintained a profoundly decentralized form of self-rule on the island, while being located sufficiently close to the mainland to have pursued massive slave raiding in prior centuries, initially becoming immersed in globally oriented mercantile relations via trade with independent colonial settler-farmers and then via “development” and partial monetarization in the postcolonial era.
The term “golden hour” describes the first 60 minutes after patients sustain injury. In resource-available settings, rapid transport to trauma centers within this time period is standard-of-care. We compared transport times of injured civilians in modern conflict zones to assess the degree to which injured civilians are transported within the golden hour in these environments.
We evaluated PubMed, Ovid, and Web of Science databases for manuscripts describing transport time after trauma among civilian victims of trauma from January 1990 to November 2017.
The initial database search identified 2704 abstracts. Twenty-nine studies met inclusion and exclusion criteria. Conflicts in Yugoslavia/Bosnia/Herzegovina, Syria, Afghanistan, Iraq, Israel, Cambodia, Somalia, Georgia, Lebanon, Nigeria, Democratic Republic of Congo, and Turkey were represented, describing 47 273 patients. Only 7 (24%) manuscripts described transport times under 1 hour. Transport typically required several hours to days.
Anticipated transport times have important implications for field triage of injured persons in civilian conflict settings because existing overburdened civilian health care systems may become further overwhelmed if in-hospital health capacity is unable to keep pace with inflow of the severely wounded.
Prisons in England and Wales have reached a low point in service delivery. Despite initial improvements after National Health Service transfer in 2006, it has deteriorated since 2010, with numerous reports giving cause for concern. Improvements are now urgently required, and political courage and a revised national programme of expenditure are necessary.
Introduction: Frailty is a state of vulnerability affecting older adults, and has been associated with adverse events such as increased risk of institutionalization, falls, functional decline, and mortality. Previous research suggests that emergency department (ED) physicians are much less comfortable managing the complex care needs of frail, older adults. The objective of this study was to identify successful strategies and expert skills that ED physicians possess to optimally manage the frail, older patient. Methods: An interpretive descriptive qualitative study was conducted. One of the investigators contacted the site leads of 12 academic and community EDs across Canada to identify ED physicians who they perceived as being highly skilled in the care of frail, older patients. 22 individual physicians were identified and 13 physicians representing 10 EDs were invited to participate in a 30-minute semi-structured interview. Transcripts were coded by two members of the research team. Data collection is ongoing and analyses will occur until thematic saturation. Results: All participants indicated they were very comfortable managing the frail, older patient in the ED. Awareness of issues related to this patient population were triggered by both clinical and personal experiences, as well as institutional priorities. When asked how they developed their specific skills for this patient population, participants stated they received limited formal training during residency and early practise, but relied on situational learning, access to role models and engagement in self-directed learning. Participants identified three predominant management strategies for the care of the frail, older patient: thorough patient interaction at the start of the clinical encounter to maximize efficiency; engaging in teamwork to manage complex issues; and early involvement of the family/caregivers. Interestingly, not all participants used the term frailty, however most reflected principles of the concept in their discussion. Conclusion: Currently, principles of caring for frail, older adults are not widespread in emergency medicine residency training. These findings suggest that frailty care frequently requires an alternative clinical approach, which is often derived from personal experience, self-directed and experiential learning. Future educational initiatives should derive, implement and evaluate a wide-spread curriculum to teach the skills required to optimally care for these patients.
The effect of cooling rate on the phase composition of gas atomized Raney type catalysts was studied using the Ni-75 at.% Al composition. The resulting particles were sieved into 3 standard size fractions and analysed using XRD with Rietveld refinement: as expected the three phases, Al₃Ni₂, Al₃Ni, and Al-Al₃Ni eutectic were identified. Differing phase compositions in the 3 size ranges were identified offering a possible explanation for varying catalytic activity with cooling rate, the higher cooling rates experienced by the smaller droplets allow less time for the peritectic conversion of Al₃Ni₂ to Al₃Ni to proceed. This in turn results in a more Al-rich residual liquid, increasing the volume fraction of eutectic. This was further confirmed when analysing the microstructure using SEM backscatter imaging. Al₃Ni₂ was found to be encased in a shell of Al₃Ni characteristic of peritectic reactions. The remainder of the alloy was found to consist of Al-Al₃Ni eutectic. The SEM backscatter imaging also indicated that the larger particles displayed and a more globular structure than smaller particles. Similar Raney type Ni-75 at.% Al doped with 1.5 at.% Cr were synthesised using the same method and sieved into the same 3 standard size fractions. It was found that the Cr doped alloys exhibited a more dendritic character than the undoped samples in the corresponding size fraction, although the material still displayed an increasingly dendritic character with increasing cooling rate. The phase composition found by Rietveld refinement also followed a similar trend to the undoped samples with decreasing amounts of Al₃Ni formed at the higher cooling rates. However, significant amounts of an additional phase, Al₁₃Cr₂, were also observed. Rietveld refinement found that a larger amount of Al₁₃Cr₂ was present than could be accounted for by the addition of 1.5 at.% Cr . This can be explained by the substitution of Ni onto the Cr lattice, as confirmed by Rietveld refinement. Al₁₃Cr₂ was found to be located mostly at the boundary of the Al₃Ni and Al-Al₃Ni eutectic phases during elemental mapping and quantitative image analysis of backscattered electron micrographs. This indicates that precipitation of Al₁₃Cr₂ is towards the end of the solidification process. The relatively large amounts of the Al-rich Al₁₃Cr₂ may explain the enhanced catalytic activity observed following leaching of Cr-doped Raney catalysts.
This ethnographic article explores the manner in which the Los Angeles Community Action Network (LACAN), a grassroots organization made up of homeless and low‐income Skid Row residents, generates video evidence for use in lawsuits against the Los Angeles Police Department (LAPD). For marginalized communities fighting police abuse, the 1992 acquittal of four LAPD officers charged with the beating of Rodney King demonstrated that even the most “obvious” and condemning video evidence is subject to reinterpretation and reframing by skilled legal professionals. In response, LACAN has developed interactional filming strategies designed to constrain officers' ability to offer alternative explanations, while alleviating disparities in court‐recognized authority. In the tradition of legal consciousness scholarship, this article “de‐centers” the law by shifting emphasis from formal judicial decisions in the courtroom to citizen groups in their own communities, as they learn to use legal norms and conventions in social justice campaigns.
Urban police officers concentrate much attention on individuals who experience various forms of inequality. Some police tactics that address the socially marginal garner public concern, especially when violence occurs. Solutions to such police-community tensions are elusive, in part because police cannot meaningfully reduce inequality. Yet there are better and worse ways to police the impoverished, and we use this article to contrast three general approaches: aggressive patrol, coercive benevolence, and officer-assisted harm reduction. We contrast their operating logics and their implications for police practice and tactics. We find great merit in officer-assisted harm reduction, which is a nascent effort. Pioneered in Seattle, it helps to reorient police culture and practice and enables efforts to address some of the challenges facing many impoverished individuals. Although its widespread adoption will not eliminate police-community tension in poor communities, it is superior to other alternatives, and thus deserves replication.
As governments grapple with increased risks associated with more frequent and impactful disasters, climate change, social inequity, urbanization, and aging infrastructure, questions about resilience take on greater urgency. The US National Academies of Sciences, Engineering, and Medicine strive for science to be beneficial to society. In 2012, the National Academies released a report, Disaster Resilience: A National Imperative, that provided recommendations around critical issues of resilience and strategic steps the United States could take towards building disaster resilience. A new program, the Resilient America Program, was created as an outgrowth of that report. Its core mission is to partner with communities across the nation to help decision-makers identify key priorities for their community; tie those priorities to relevant risks; and identify actions that build resilience to those risks. The Resilient America Program is a novel program of the National Academies; it employs a hands-on approach to bring science into decision-making by working directly with decision-makers to test approaches for communicating and managing risk, measuring resilience, building community partnerships, and sharing relevant resilience information.