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A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
Nurses’ broad knowledge and treatment skills are instrumental to disaster management. Roles, responsibilities, and practice take on additional dimensions to their regular roles during these times. Despite this crucial position, the literature indicates a gap between their actual work in emergencies and the investment in training and establishing response plans.
To explore trends in disaster nursing reflected in professional literature, link these trends to current disaster nursing competencies and standards, and reflect based on the literature how nursing can better contribute to disaster management.
A systematic literature review, conducted using six electronic databases, and examination of peer-reviewed English journal articles. Selected publications were examined to explore the domains of disaster nursing: policy, education, practice, research. Additional considerations were the scope of the paper: local, national, regional, or international. The International Nursing Councils’ (ICN) Disaster-Nursing competencies are examined in this context.
The search yielded 171 articles that met the inclusion criteria. Articles were published between 2001 and 2018, showing an annual increase. Of the articles, 48% (n = 82) were research studies and 12% (n = 20) were defined as dealing with management issues. Classified by domain, 48% (n = 82) dealt with practical implications of disaster nursing and 35% (n = 60) discussed educational issues. Only 11% of the papers reviewed policy matters, and of these, two included research. Classified by scope, about 11% (n =18) had an international perspective.
Current standards attribute a greater role to disaster-nursing in leadership in disaster preparedness, particularly from a policy perspective. However, this study indicates that only about 11% of publications reviewed policy issues and management matters. A high percentage of educational publications discuss the importance of including disaster nursing issues in the curricula. In order to advance this area, there is a need to conduct dedicated studies.
Long exposures with the 4-Shooter at the Cassegrain focus of the 200-inch telescope at Palomar Observatory have been obtained for M87 (and two other giant ellipticals in Virgo). Ellipse fitting with a code specially developed to reject point sources has been carried out to determine the surface brightness in various bandpasses of the underlying galaxy. The color gradients in the galaxy are quite small over the entire regime between 2 and 350 arc-sec from the nucleus of M87. Also I find that there is no difference between the ellipse parameters (position angle and eccentricity) derived in the various colors, i.e. the isochromes and the isophotes coincide. Details of the study of the halo of M87 are described in a paper submitted to the Astronomical Journal.
Rapid improvements in instrumentation over the past few years have made the spectroscopic study of individual globular cluster giants feasable. Three years ago I began a program of high dispersion abundance analyses of such stars to provide a calibration for the many photometric systems used to rank globular clusters in metallicity. The results for four clusters (M92, M15, M13, and M3) of low and intermediate metallicity have already appeared (Cohen, 1978, 1979), and additional detailed analyses of stars in M5 and M13 (Pilachowski, Wallerstein and Leep, 1979) will soon be available. Ignoring the elements C, N, and O, to which we shall return later, these detailed abundance analyses yielded few great surprises; perhaps the metallicity scale that had previously been used was too high by about 0.2 dex, and also it became clear that M3 was a very metal poor cluster. However, the calibration of the metal rich globulars beyond the simple ranking level of Mould, Struthman, and McElroy (1979) had not been attempted.
We present initial results from our study of the outer halo of the Milky Way using a large sample of RR Lyr(ab) variables datamined from the archives of the Palomar Transient Facility. Of the 464 RR Lyr in our sample with distances exceeding 50 kpc, 62 have been observed spectroscopically at the Keck Observatory. vr and σ(vr) are given as a function of distance between 50 and 110 kpc, and a very preliminary rather low total mass for the Milky Way out to 110 kpc of ~7±1.5×1011M⊙ is derived from our data.
We present an overview of our Galactic Archaeology (GA) survey program with the Prime Focus Spectrograph (PFS) for Subaru. Following successful design reviews, the instrument is now under construction with first light anticipated in 2018. Main characteristics of PFS and the science goals in our PFS/GA program are described.
I review the evidence supporting and characterizing multiple populations within globular clusters (GCs) based on spectroscopy, i.e. on abundance variations within the stellar population of an individual GC, which dates back to almost 40 years ago. I discuss some of my recent work in this area.
Developments in information technology and the ongoing restructuring of health services to increase provision in community settings militate in favour of a streamlining of communications and the exchange of information about patients among health and social care providers. Yet the principles of confidentiality and privacy appear to inhibit this process. In order to explore the practical, ethical, and legal imperatives attendant upon personal health information exchange, we conducted a series of interviews with professional care providers, persons with early-stage dementia, and their family caregivers. The findings indicate some degree of discordance. Professionals reported valuing disclosure both to colleagues and family caregivers on the basis of its being in the patients' best interests. Patients also valued inter-professional exchange, but sought strong control over disclosure to family members. Family caregivers valued being kept informed of the patient's condition, even without the latter's consent. Implications for research and policy are discussed.
We review the properties of globular clusters (GCs) which make them useful for studying the Galactic halo, Galactic chemical evolution and the early stages of the formation of the Milky Way. We review the evidence that GCs have a chemical inventory similar to those of halo field stars. We discuss the abundance ratios for dSph galaxies and show that it is possible to have formed at least part of the Galactic-halo field stellar population by dissolving GCs and/or accreting dSph galaxies, but only if this occurred at an early stage in the formation of the Galaxy. We review the constraints on halo-formation timescales deduced from the low magnesium isotopic ratios in metal-poor halo field dwarfs, which indicate that asymptotic giant-branch (AGB) stars did not have time to contribute significantly, while M71 contains two populations, one without and also one with a substantial AGB contribution. We review the limited evidence for GCs with a second population showing additional contributions from Type II supernovae, currently confined to ω Cen, M54 and M22, all of which may have been the nuclei or central regions of accreted galaxies. We check our own data for additional similar GCs and find preliminary indications that NGC 2419, a massive GC far in the outer Galactic halo, may also belong to this group.
Low socioeconomic status (SES) background has been identified as a risk for several mental disorders. However evidence regarding SES and the developmental course of personality disorder (PD) has not been addressed. Nor is it clear whether an SES relationship to PD symptom course may be attributable to known associated risks. Further, specificity of such relationships to a particular PD diagnostic pattern independent of comorbidity with other PD or with depression has not been investigated. Data are from a general population studied longitudinally between ages 10 and 36 in four assessment waves. Effects of SES-associated risks on the level of symptoms of schizotypal and borderline disorders are estimated and compared to effects on depressive symptoms. Low family SES had robust modest independent effects on both PDs over the entire age span despite substantial cumulative effects of trauma history, stressful recent life events, IQ, poor parenting, and comorbid symptoms. SES effects on depressive symptoms were generally absent, but a small “protective” effect of low SES appeared when comorbidity with PD symptoms was taken into account. Cumulatively, these risks account for developmental failures of substantial magnitude and consequence, marking the importance of understanding the remaining mechanisms of SES effects and programmatic implications for minimizing associated risk.
The terrorist attacks of September 11, 2001, exposed every person in the USA to an experience that, in recent decades, was unprecedented in its scope and traumatic impact. Perhaps over 100,000 individuals directly witnessed these events, and many others viewed the attacks and their aftermath via the media (Yehuda, 2002). It has been argued that this national trauma “influenced and will continue to influence the clinical presentation of patients seeking health care services” in the USA (Yehuda, 2002, p. 108).
A wide range of responses can be expected following traumatic life events. Research conducted after the Oklahoma City, OK, bombing indicates that responses to a terrorist attack are likely to be highly variable (North et al., 1999). Research in the broader field of stress and coping has also demonstrated considerable variability in emotional and cognitive responses to stressful experiences (Silver & Wortman, 1980;Wortman & Silver, 1989, 2001). Despite advances in understanding reactions to traumatic events, our understanding of responses to community-level events in general, and terror attacks in particular, is limited. Progress in understanding the social and psychological process following such occurrences requires examination of how responses to a variety of stressful events are similar and different at both the group and individual level. Research has matured to the point that large-scale, prospective, longitudinal studies with the scope to examine mediators and moderators of adjustment processes are not only possible, but also necessary (North & Pfefferbaum, 2002). Moreover, the threat of future terrorist attacks demands that a higher level of urgency and research sophistication be directed not only at understanding the effects of such attacks, but also at the individual and social variables that predict psychological outcomes to such events over time.
We discuss the fraction of carbon stars (C-stars) and of C-enhanced stars among samples of candidate extremely metal poor (EMP: [Fe/H] $\le -3.0$ dex) stars selected from the Hamburg/ESO Survey (HES), obtaining a total for C-rich stars with [C/Fe] $\ge$ +1.0 dex of 14.4$\pm4$%. We also present the key results of detailed abundance analyses of a sample of 14 C-stars selected in this way.