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Disasters often occur without any warning and may result in mass casualties that can overwhelm the capacity of local and regional healthcare systems. The etiology of disasters can be man-made or natural, can be localized or effect a large geographic area, and can result in minimal harm to the population or mass casualties. The most lethal natural disasters include earthquakes, hurricanes, floods, tsunamis, snowstorms, and fires. Man-made disasters include wars, building collapses, mine cave-ins, chemical and biological exposures, nuclear accidents, and civil unrest.
Facial injuries are common and can involve both soft tissue injury and bony injury. These often occur because of motor vehicle collisions, secondary to direct impact against the windshield, steering wheel, or dashboard, as well as from broken glass fragments, causing lacerations and eye injuries. Many facial injuries also occur because of physical assault or because of falls to the head and face, especially in the elderly, who are less able to protect their face while falling.
Orthopedic injuries are found in approximately 85% of blunt trauma victims; thus knowledge of their evaluation and treatment is important. Some of these injuries are also acutely life- or limb-threatening and need to be treated in an expedited fashion. Despite the importance of early treatment, the standard primary survey promulgated by the ATLS course is necessary to detect other injuries that have a higher priority. During the primary survey, the only attention to musculoskeletal injury is acute hemorrhage control with direct pressure.
This article historicizes musical symbolism in Melvin B. Tolson's poem “Dark Symphony” (1941). In a time when Black writers and musicians alike were encouraged to aspire to European standards of greatness, Tolson's Afro-modernist poem establishes an ambivalent critical stance toward the genre in its title. In pursuit of a richer understanding of the poet's attitude, this article situates the poem within histories of Black music, racial uplift, and white supremacy, exploring the poem's relation to other media from the Harlem Renaissance. It analyzes the changing language across the poem's sections and, informed by Houston A. Baker Jr.'s study of “mastery and deformation,” theorizes the poet's tone. While prior critics have read the poem's lofty conclusion as sincerely aspirational toward assimilation, this article emphasizes the ambiguity, or irony, that Tolson develops: he embraces the symphony's capacity as a symbol to encompass multiple meanings, using the genre metaphorically as a mark of achievement, even as he implicates such usage as a practice rooted in conservative thought. The “symphony,” celebrated as a symbol of pluralistic democracy and liberal progress, meanwhile functions to reinforce racialized difference and inequality—a duality that becomes apparent when this poem is read alongside Tolson's concurrent poems, notes, and criticism. Such analysis demonstrates that “Dark Symphony” functions as a site for heightened consciousness of racialized musical language, giving shape to Tolson's ideas as a critic, educator, and advocate for public health.
This chapter provides a synthesis of the information presented in the previous chapters. First, the empirical evidence presented in Chapters 3 and 4 is evaluated in relation to the theoretical ideas described in Chapter 2. This is achieved through the evaluation of some tentative propositions, based on available theory. Selected issues that emerged during the review of empirical evidence are then considered, and an attempt is made to answer the overarching questions identified at the start of the book. A second section then examines the implications of our current understanding for conservation policy and practice. Specifically, how can we avert the collapse of ecosystems and support their recovery?
The chapter first considers the nature of ecological theory, then provides an overview of a series of different theoretical ideas in relation to ecosystem collapse and recovery. These include disturbance theory, succession, state-and-transition models, dynamical systems theory, planetary boundaries, critical loads, resilience, food webs, ecological networks and extinction cascades. A set of propositions are then presented that might provide a basis for understanding ecosystem collapse and recovery, based on these theories. These propositions are revisited in subsequent chapters, in light of the empirical evidence that is considered.
Provides a brief overview of the context of the book and the approach adopted. This chapter provides a brief introduction to the topics covered by the book and also provides an overview of how the book is structured. The IUCN Red List of Ecosystems is described and then a number of key terms are defined, including ecosystem, ecosystem collapse and ecosystem recovery. The role of metaphor in ecology is considered and then the concept of ecosystem collapse is evaluated, in terms of its relevance to environmental policy and management.
Let K/k be an extension of number fields. We describe theoretical results and computational methods for calculating the obstruction to the Hasse norm principle for K/k and the defect of weak approximation for the norm one torus
. We apply our techniques to give explicit and computable formulae for the obstruction to the Hasse norm principle and the defect of weak approximation when the normal closure of K/k has symmetric or alternating Galois group.
This chapter provides a brief summary of some of the key findings of this book, first by considering the answers to questions posed at the beginning, then via a series of summary statements and provocations.
This chapter profiles examples of ecosystem collapse and recovery in prehistory. First, the ‘Big Five’ mass extinction events in the fossil record are considered, both in terms of the collapses that occurred and how ecosystems subsequently recovered. Examples from the Quaternary Period are then discussed, including the extinction of the Australian megafauna and the slightly later megafauna extinctions observed in other geographic regions. Case studies profiled from the Holocene period focus on the spread of agriculture throughout the world and the specific cases of New Zealand, Madagascar and the Sahel-Sahara. At the end of the chapter, the theoretical propositions identified in Chapter 2 are then evaluated in the light of the empirical evidence available from prehistory.
This chapter profiles contemporary examples of ecosystem collapse and recovery. Case studies presented include coral reefs, marine fisheries, freshwater ecosystems (streams, rivers and lakes), forests (including tropical, temperate and boreal), savanna, and temperate agroecosystems. In each case, the available empirical evidence is reviewed in relation to the ecological mechanisms underlying both ecosystem collapse and recovery. At the end of the chapter, the theoretical propositions identified in Chapter 2 and refined in Chapter 3 are then evaluated in the light of the evidence available from these contemporary case studies.
In the wake of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, rapid identification of pediatric mental health risk is extremely important. The Western Regional Alliance for Pediatric Emergency Management held an integrated, interdisciplinary national tabletop exercise to familiarize mental health and non-mental health professionals with Psychological Simple Triage and Rapid Treatment (PsySTART), an evidence-based triage and incident management system used to evaluate new mental health risk impacts following exposure to traumatic events, such as coronavirus disease (COVID-19).
Participants Participants were exposed to 3 practice cases that reflected a combination of “all hazards” scenarios and were asked to triage each case using PsySTART. Participants were asked to interpret results at both an individual site and aggregate county and/or state level.
The exercise had a total of 115 participants with a total of 156 discrete triage encounters. A user-defined operating picture was created with graphs of aggregate mental health risk data, generating cross-regional, real-time situational awareness. After the exercise, a vast majority of the participants reported confidence in their ability to use PsySTART in their practices.
Participants are now better equipped with tools to perform mental health triage for early intervention during COVID-19 and other disasters and understand risk on a population level.
Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.
There is a growing concern that many important ecosystems, such as coral reefs and tropical rain forests, might be at risk of sudden collapse as a result of human disturbance. At the same time, efforts to support the recovery of degraded ecosystems are increasing, through approaches such as ecological restoration and rewilding. Given the dependence of human livelihoods on the multiple benefits provided by ecosystems, there is an urgent need to understand the situations under which ecosystem collapse can occur, and how ecosystem recovery can best be supported. To help develop this understanding, this volume provides the first scientific account of the ecological mechanisms associated with the collapse of ecosystems and their subsequent recovery. After providing an overview of relevant theory, the text evaluates these ideas in the light of available empirical evidence, by profiling case studies drawn from both contemporary and prehistoric ecosystems. Implications for conservation policy and practice are then examined.