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A leader from Quebec boosts the fortunes of the Liberal party in that province. This, in turn, has helped make Quebec the veto player in twentieth-century Canadian elections and the Liberals the “natural” governing party. Although Quebec is no longer as critical as before, a leader from the province still makes a big difference. Full impact from the pattern requires more than one election to unfold. Patterns outside Quebec are similar, if fainter: the Liberal party is not punished for choosing a Quebecker and may even be helped. The early success of the pattern moved the Liberals to alternate between Quebec and non-Quebec leaders, such that the party is now led by a Quebecker more often than not. Maintaining alternation has never been easy and is only getting harder.
During mass gatherings, such as marathons, the provision of timely access to health care services is required for the mass gathering population as well as the local community. However, effective provision of health care during sporting mass gatherings is not well understood.
To describe the structures and processes developed for an emergency team to operate an in-event acute health care facility during one of the largest mass sporting participation events in the southern hemisphere, the Gold Coast marathon.
A pragmatic qualitative methodology was used to describe the structures and processes required to operate an in-event acute health care facility providing services for marathon runners and spectators. Content analysis from 12 semi-structured interviews with Emergency Department (ED) clinical staff working during the two-day event was undertaken in 2016.
Structural elements that underpinned the in-event health care facility included: physical spaces such as the clinical zones in the marathon health tent, tent access, and egress points; and resources such as bilingual staff, senior medical staff, and equipment such as electrocardiograms. Critical processes included: clear communication pathways, interprofessional care coordination, and engagement involving shared knowledge of and access to resources. Distinct but overlapping clinical scope between nurses and doctors was also noted as important for timely care provision and appropriate case management. Staff outlined many perceived benefits and opportunities of in-event health care delivery including ED avoidance and disaster training.
This in-event model of emergency care delivery enabled acute out-of-hospital health care to be delivered in a portable and transportable facility. Clinical staff reported satisfaction with their ability to provide a meaningful contribution to hospital avoidance and to the local community. With the number of sporting mass gatherings increasing, this temporary, in-event model of health care provision is one option for event and health care planners to consider.
Mass gatherings such as marathons are increasingly frequent. During mass gatherings, the provision of timely access to health care services is required for the mass-gathering population, as well as for the local community. However, the nature and impact of health care provision during sporting mass gatherings is not well-understood.
The aim of this study was to describe the structures and processes developed for an emergency health team to operate an in-event, acute health care facility during one of the largest mass-sporting participation events in the southern hemisphere, the Gold Coast Marathon (Queensland, Australia).
A pragmatic, qualitative methodology was used to describe the structures and processes required to operate an in-event, acute health care facility providing services for marathon runners and spectators. Content analysis from 12 semi-structured interviews with emergency department (ED) clinical staff working during the two-day event was undertaken in 2016.
Important structural elements of the in-event health care facility included: physical spaces, such as the clinical zones in the marathon health tent and surrounding area, and access and egress points; and resources such as bilingual staff, senior medical staff, and equipment such as electrocardiograms (ECGs) and intravenous fluids. Process elements of the in-event health care facility included clear communication pathways, as well as inter-professional care coordination and engagement involving shared knowledge of and access to resources, and distinct but overlapping clinical scope between nurses and doctors. This was seen to be critical for timely care provision and appropriate case management. Staff reported many perceived benefits and opportunities of in-event health care delivery, including ED avoidance and disaster training.
This in-event model of emergency care delivery, established in an out-of-hospital location, enabled the delivery of acute health care that could be clearly described and defined. Staff reported satisfaction with their ability to provide a meaningful contribution to hospital avoidance and to the local community. With the number of sporting mass gatherings increasing, this temporary, in-event model of health care provision is one option for event and health care planners to consider.
JohnstonANB, WadhamJ, Polong-BrownJ, AitkenM, RanseJ, HuttonA, RichardsB, CrillyJ.Health Care Provision During a Sporting Mass Gathering: A Structure and Process Description of On-Site Care Delivery. Prehosp Disaster Med. 2019;34(1):62–71.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative condition that primarily affects motor neurons. Cognitive changes are reported in 25%-50% of patients, secondary to frontotemporal involvement. The objective of this study was to evaluate the utility of a screening tool, the Addenbrooke’s Cognitive Examination (ACE), in ALS patients.
In this retrospective cross-sectional study, performance on the ACE was compared between 55 ALS patients and 49 healthy controls. The validation of the ACE in ALS patients was explored using a neuropsychometric battery. Correlations between the ACE and clinical variables such as the ALS Functional Rating Scale-Revised (ALSFRS-R) and forced vital capacity were computed.
A higher percentage of patients were below cut-off scores, although this remained non-significant between the patient and control groups. The ACE did not reveal significant differences between ALS patients and controls. The scores on the ACE displayed moderate correlations with our neuropsychometric battery for some domains, whereas others showed poor or no associations. Poor ACE Total was associated with lower ALSFRS-R and finger-tapping scores.
Performance on the ACE was comparable between patients and controls. Associations with motor function pose a challenge to accurate interpretation of ACE performance. It is likely that patients with poor cognition have greater disability, or that poor ACE performance reflects reduced motor ability to perform the task. This raises concern for the utility of the ACE as a screening tool in ALS patients, especially since recent versions of the ACE continue to include motor-based tasks.
Do increasing, and increasingly diverse, immigration flows lead to declining support for redistributive policy? This concern is pervasive in the literatures on immigration, multiculturalism and redistribution, and in public debate as well. The literature is nevertheless unable to disentangle the degree to which welfare chauvinism is related to (a) immigrant status or (b) ethnic difference. This paper reports on results from a web-based experiment designed to shed light on this issue. Representative samples from the United States, Quebec, and the “Rest-of-Canada” responded to a vignette in which a hypothetical social assistance recipient was presented as some combination of immigrant or not, and Caucasian or not. Results from the randomized manipulation suggest that while ethnic difference matters to welfare attitudes, in these countries it is immigrant status that matters most. These findings are discussed in light of the politics of diversity and recognition, and the capacity of national policies to address inequalities.
Objectives: To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. Methods: We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. Results: 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Conclusion: Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.
NASA’s Space Interferometry Mission (SIM), scheduled for launch in 2009, will determine the positions of thousands of stars as faint as V = 20 to a precision better than 4 microarcseconds (µas). A key part of the mission is the Astrometric Grid, which is a reference frame of several thousand stars with V ≤ 13 against which all relative measurements will be calibrated. To serve as a reliable inertial reference frame, the Grid must be astrometrically stable against photocenter jitter (from planets, binary companions, flaring or spotting) at the ~ 4µas level. Sub–solar metallicity giant stars, by virtue of their intrinsic luminosity, can probe the Galaxy to greater distances than almost any other stellar type at the same apparent magnitude. Thus, distant (> 3 kpc) giants with V < 13 will have proportionately smaller astrometric jitter compared to other potential Astrometric Grid star candidates. The Grid Giant Star Survey is a patchwork all-sky survey to find sub–solar metallicity K giants for the Grid, and to provide a unique database for studies of Galactic stellar populations. We describe here the survey characteristics and give examples of results to date.
The Full-sky Astrometric Mapping Explorer (FAME) is designed to perform an all-sky, astrometric survey with unprecedented accuracy. It will create a rigid astrometric catalog of 4 × 107 stars with 5 < mV < 15. For bright stars, 5 < mV < 9, FAME will determine positions and parallaxes accurate to < 50 μas, with proper motion errors < 50 μas/yr. For fainter stars, 9 < mV < 15, FAME will determine positions and parallaxes accurate to < 500 μas, with proper motion errors < 500 μas/yr. It will also collect photometric data on these 4 × 107 stars in four Sloan Digital Sky Survey colors. NASA selected FAME to be one of five MIDEX missions funded for a concept study. In October 1999, NASA selected FAME for launch in 2004 as the MIDEX-4 mission in its Explorer program.
The proposed Fast All Sky Telescope (FAST) is an interferometer which is intended to monitor the northern four-fifths of the celestial sphere every two days at 8.1 GHz and daily at 2.7 GHz. The design goal is to have a rms sensitivity of 10 mJy/beam at both frequencies. The array is planned to comprise 20 3-meter diameter antennas with a maximum baseline of 0.7 km. FAST will provide a valuable database that may be used to study time variability in a sensitivity limited sample of radio sources. This will significantly impact on the understanding of active Galactic and extragalactic radio sources, as well as on the understanding of radio wave scattering in the interstellar medium.
We review briefly the general properties of halo and relic sources in galaxy clusters. We also present a polarized radiative transfer algorithm which is useful for calculations of polarized radio emission from halos, relics and active galaxies in a magnetized intra-cluster medium.