The application and provision of prehospital care in disasters and mass-casualty incident response in Europe is currently being explored for opportunities to improve practice. The objective of this translational science study was to align common principles of approach and action and to identify how technology can assist and enhance response. To achieve this objective, the application of a modified Delphi methodology study based on statements derived from key findings of a scoping review was undertaken. This resulted in 18 triage, eight life support and damage control interventions, and 23 process consensus statements. These findings will be utilized in the development of evidence-based prehospital mass-casualty incident response tools and guidelines.

A standard informal method for analyzing the asymptotic complexity of a program is to extract a recurrence that describes its cost in terms of the size of its input and then to compute a closed-form upper bound on that recurrence. We give a formal account of that method for functional programs in a higher order language with $\mathtt{let}$-polymorphism. The method consists of two phases. In the first phase, a monadic translation is performed to extract a cost-annotated version of the original program. In the second phase, the extracted program is interpreted in a model. The key feature of this second phase is that different models describe different notions of size. This plays out in several ways. For example, when analyzing functions that take arguments of inductive types, different notions of size may be appropriate depending on the analysis. When analyzing polymorphic functions, our approach shows that one can formally describe the notion of size of an argument in terms of the data that is common to the notions of size for each type instance of the domain type. We give several examples of different models that formally justify various informal cost analyses to show the applicability of our approach.

Guided by principles from life-history theory, theories of adaptive calibration provide an overarching theoretical framework for understanding the developmental roots of impulsivity and externalizing psychopathology. The current research provides evidence for robust associations between perceptions of childhood unpredictability, delay discounting (Studies 1a and 1b), and adult externalizing traits and behaviors (Study 2). Both associations were observed while controlling for perceptions of the harshness of childhood environments, as well as a range of demographic characteristics. The association with externalizing traits and behavior was observed over and above current mood and depressive symptoms. Study 2 also replicated a previously documented association between changes in maternal employment, residence, and cohabitation during childhood and externalizing behavior and, furthermore, suggested that this association was mediated by perceptions of unpredictability. These studies provided no evidence for links between perceived childhood unpredictability and basic forms of risk-taking (Studies 1a and 1c). This research adds to a growing body of work leveraging principles from life-history theory to demonstrate links between childhood experiences, impulsivity, and potentially debilitating forms of mental illness. This work also highlights the value of assessing people’s perceptions of their childhood environments.

In A Theory of Justice, John Rawls defines a hypothetical contract situation and argues rational people will agree on reflection it is fair to contractors. He solves the rational choice problem it poses by deriving two lexically-ordered principles of justice and suggests the derivation justifies the principles. Its soundness aside, just what justificatory force does such a derivation have?

On one view, there is no justificatory force because the contract is rigged specifically to yield principles which match our pre-contract moral judgments. Rawls provides ammunition for this claim: “By going back and forth, sometimes altering the conditions of the contractual circumstances, at others withdrawing our judgments [about what is just] and conforming them to principle, I assume that eventually we shall find a description of the initial situation that both expresses reasonable conditions and yields principles which match our considered judgments duly pruned and adjusted.”

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.

Knowledge of the surface composition of planetary bodies comes from a number of sources; such as landers, remote sensing and meteorites. However, the bulk mapping of the composition of planetary surfaces has been undertaken by analysis of reflected sunlight and these data—principally collected in the near-infra-red (IR) region—are notoriously broad and ambiguous. Hence, if laboratory spectra could be tied to physical properties measurements, such as diffraction, this would substantially aid our understanding of processes occurring in these extra-terrestrial environments. This contribution presents the capability of collecting near-IR data at the same time as neutron and synchrotron X-ray diffraction in a range of conditions (low temperature, vacuum, and humidity variations) and highlights two examples where this capability could enhance our understanding of planetary surfaces.

Healthcare technology assessment (HTA) aims to support decisions as to which technologies should be used in which situations to optimize value. Because such decisions will create winners and losers, they are bound to be controversial. HTA, then, faces a dilemma: should it stay away from such controversies, remaining a source of incomplete advice and risking an important kind of marginalization, or should it enter the controversy? The question is a challenging one, because we lack agreement on principles that are fine grained enough to tell us what choices we should make. In this study, we will argue that HTA should take a stand on ethical issues raised by the technology that is being investigated. To do so, we propose adding a form of procedural justice to HTA to arrive at decisions that the public can regard as legitimate and fair. A fair process involves deliberation about the reasons, evidence, and rationales that are considered relevant to meeting population-health needs fairly. One important way to make sure that there is real deliberation about relevant reasons is to include a range of stakeholders in the deliberative process. To illustrate how such deliberation might work, we use the case of cochlear implants for deaf children.

Resilience after a nuclear power plant or other radiation emergency requires response and recovery activities that are appropriately safe, timely, effective, and well organized. Timely informed decisions must be made, and the logic behind them communicated during the evolution of the incident before the final outcome is known. Based on our experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, we propose a real-time, medical decision model by which to make key health-related decisions that are central drivers to the overall incident management. Using this approach, on-site decision makers empowered to make interim decisions can act without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Ongoing assessment, consultation, and adaption to the changing conditions and additional information are additional key features. Given the central role of health and medical issues in all disasters, we propose that this medical decision model, which is compatible with the existing US National Response Framework structure, be considered for effective management of complex, large-scale, and large-consequence incidents. (Disaster Med Public Health Preparedness. 2012;0:1-10)