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Millions of people visit US national parks annually to engage in recreational wilderness activities, which can occasionally result in traumatic injuries that require timely, high-level care. However, no study to date has specifically examined timely access to trauma centers from national parks. This study aimed to examine the accessibility of trauma care from national parks by calculating the travel time by ground and air from each park to its nearest trauma center. Using these calculations, the percentage of parks by census region with timely access to a trauma center was determined.
This was a cross-sectional study analyzing travel times by ground and air transport between national parks and their closest adult advanced trauma center (ATC) in 2018. A list of parks was compiled from the National Parks Service (NPS) website, and the location of trauma centers from the 2018 National Emergency Department Inventory (NEDI)-USA database. Ground and air transport times were calculated using Google Maps and ArcGIS, with medians and interquartile ranges reported by US census region. Percentage of parks by region with timely trauma center access—defined as access within 60 minutes of travel time—were determined based on these calculated travel times.
In 2018, 83% of national parks had access to an adult ATC within 60 minutes of air travel, while only 26% had timely access by ground. Trauma center access varied by region, with median travel times highest in the West for both air and ground transport. At a national level, national parks were unequally distributed, with the West housing the most parks of all regions.
While most national parks had timely access to a trauma center by air travel, significant gaps in access remain for ground, the extent of which varies greatly by region. To improve the accessibility of trauma center expertise from national parks, the study highlights the potential that increased implementation of trauma telehealth in emergency departments (EDs) may have in bridging these gaps.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
Ionic piezoresistance, the effect of lattice strain on ionic conductivity, is an important concept that needs to be harnessed to engineer the next generation of fast ionic conductors. To date there have been many reports of strain affecting changes in the level of ionic conductivity in solid electrolytes. The fundamental understanding is, however, still lacking, with limited experimental quantification of the magnitude of the effect. Here, we propose using the ionic piezoresistive coefficient, the constant of proportionality between the strain state and the change in conductivity, as a quantitative measure of this effect and detail a novel technique we have developed to quantify this in high temperature ionically conducting materials.
The grey-winged cotinga Tijuca condita was first described in 1980 from an old specimen, misidentified as a congener. Field observations came later, from two remote, high-elevation forests in the mountains of Rio de Janeiro, Brazil. Both involved only a few pairs of birds at best, making this species one of the least known in the world. Accurately defining the locations this species inhabits is an obvious prerequisite for designing conservation strategies to protect it. Using remotely sensed data on elevation and forest cover we mapped this species’ habitat and predicted six more sites where it may occur. Field surveys confirmed two of them, doubling the known range of the species. The two easternmost predicted sites did not contain the species but these areas have less annual rainfall than other sites, which may explain the absences. This research serves as an important guide to conservation actions, for it uncovered biologically important areas for this species that had been previously overlooked. It has also measured the remaining habitat of the species so that any future losses can be detected.