The late Holocene Bonneville landslide, a 15.5 km2 rockslide-debris avalanche, descended 1000 m from the north side of the Columbia River Gorge and dammed the Columbia River where it bisects the Cascade Range of Oregon and Washington, USA. The landslide, inundation, and overtopping created persistent geomorphic, ecologic, and cultural consequences to the river corridor, reported by Indigenous narratives and explorer accounts, as well as scientists and engineers. From new dendrochronology and radiocarbon dating of three trees killed by the landslide, one entrained and buried by the landslide and two killed by rising water in the impounded Columbia River upstream of the blockage, we find (1) the two drowned trees and the buried tree died the same year, and (2) the age of tree death, and hence the landslide (determined by combined results of nine radiocarbon analyses of samples from the three trees), falls within AD 1421–1455 (3σ confidence interval). This result provides temporal context for the tremendous physical, ecological, and cultural effects of the landslide, as well as possible triggering mechanisms. The age precludes the last Cascadia Subduction Zone earthquake of AD 1700 as a landslide trigger, but not earlier subduction zone or local crustal earthquakes.

Hypertrophic cardiomyopathy has a range of clinical severity in children. Treatment options are limited, mainly on account of small patient size. Disopyramide is a sodium channel blocker with negative inotropic properties that effectively reduces left ventricular outflow tract gradients in adults with hypertrophic cardiomyopathy, but its efficacy in children is uncertain. A retrospective chart review of patients ⩽21 years of age with hypertrophic cardiomyopathy at our institution and treated with disopyramide was performed. Left ventricular outflow tract Doppler gradients before and after disopyramide initiation were compared as the primary outcome measure. Nine patients received disopyramide, with a median age of 5.6 years (range 6 days–12.9 years). The median left ventricular outflow tract Doppler gradient before initiation of disopyramide was 81 mmHg (range 30–132 mmHg); eight patients had post-initiation echocardiograms, in which the median lowest recorded Doppler gradient was 43 mmHg (range 15–100 mmHg), for a median % reduction of 58.2% (p=0.002). With median follow-up of 2.5 years, eight of nine patients were still alive, although disopyramide had been discontinued in six of the nine patients. Reasons for discontinuation included septal myomectomy (four patients), heart transplantation (one patient), and side effects (one patient). Disopyramide was effective for the relief of left ventricular outflow tract obstruction in children with hypertrophic cardiomyopathy, although longer-term data suggest that its efficacy is not sustained. In general, it was well tolerated. Further study in larger patient populations is warranted.

Coastal ecosystems are particularly vulnerable to alien invasions. Regular, standardized, targeted monitoring of coastal areas helps to detect the arrival of non-native species early, identify sites most vulnerable to invasion, and assess potential for further spread. This study quantified the spread and changes in distribution of non-native oyster, Crassostrea gigas, populations around the coast of Ireland. In total 37 sites were surveyed, in areas which either currently or previously harboured cultivated C. gigas, for the presence and abundance of ‘wild’ C. gigas. Wild populations were identified at 20 sites and at four additional sites C. gigas was observed as recently discarded from aquaculture activity. Five of the invaded sites were identified as being highly suitable for a population expansion based on their current population status. Importantly, we also identified individuals of C. gigas and native European oysters, Ostrea edulis, co-occurring within the same shore at five sites. This is the first record to our knowledge of such co-occurrence within Europe. This evidence of co-existing oyster species raises concerns regarding the potential impact of C. gigas on recovering O. edulis populations. In Ireland, however, C. gigas does not typically spread extensively from introduction points, and although self-containing populations exist, they are currently sustained at a much lower density than those observed in other regions such as the Wadden Sea or French Atlantic coasts. We suggest, therefore, that to protect native oyster populations, C. gigas should be eradicated where co-occurring with O. edulis and recommend continuous monitoring of invaded sites.

Environmental and natural resource economists could be more effectively engaged in great research on exciting issues in environmental and natural resource management. After identifying possible obstacles to improved research, the article focuses on opportunities and obstacles associated with obtaining funding from the National Science Foundation. Opportunities abound, both ongoing and in the future, for interdisciplinary work involving environmental and natural resource economists. Keys to exploiting these opportunities for funding include a willingness to face rejection, build teams, contact program officers with specific questions, write detailed research designs, and prepare proposals that promise to go beyond narrow incremental advances.

Mass casualty triage is the process of prioritizing multiple victims when resources are not sufficient to treat everyone immediately. No national guideline for mass casualty triage exists in the United States. The lack of a national guideline has resulted in variability in triage processes, tags, and nomenclature. This variability has the potential to inject confusion and miscommunication into the disaster incident, particularly when multiple jurisdictions are involved. The Model Uniform Core Criteria for Mass Casualty Triage were developed to be a national guideline for mass casualty triage to ensure interoperability and standardization when responding to a mass casualty incident. The Core Criteria consist of 4 categories: general considerations, global sorting, lifesaving interventions, and individual assessment of triage category. The criteria within each of these categories were developed by a workgroup of experts representing national stakeholder organizations who used the best available science and, when necessary, consensus opinion. This article describes how the Model Uniform Core Criteria for Mass Casualty Triage were developed.

(Disaster Med Public Health Preparedness. 2011;5:129-137)

Mass casualty triage is a critical skill. Although many systems exist to guide providers in making triage decisions, there is little scientific evidence available to demonstrate that any of the available systems have been validated. Furthermore, in the United States there is little consistency from one jurisdiction to the next in the application of mass casualty triage methodology. There are no nationally agreed upon categories or color designations. This review reports on a consensus committee process used to evaluate and compare commonly used triage systems, and to develop a proposed national mass casualty triage guideline. The proposed guideline, entitled SALT (sort, assess, life-saving interventions, treatment and/or transport) triage, was developed based on the best available science and consensus opinion. It incorporates aspects from all of the existing triage systems to create a single overarching guide for unifying the mass casualty triage process across the United States. (Disaster Med Public Health Preparedness. 2008;2(Suppl 1):S25–S34)

In adolescence, antisocial and depressive symptoms are moderately stable and modestly correlated with each other. We examined the genetic and environmental origins of the stability and change of antisocial and depressive symptoms and their co-occurrence cross-sectionally and longitudinally in a national sample of 405 adolescents. Monozygotic (MZ) and dizygotic (DZ) twins and full, half, and unrelated siblings 10–18 years of age from nondivorced and stepfamilies were studied over a 3-year period. Composite measures of adolescent self-reports, parent reports, and observational measures of antisocial and depressive symptoms were analysed in multivariate behavioural genetic models. Results indicated that the majority of the stability in and co-occurrence between dimensions could be accounted for by genetic factors. Nonshared environmental risks and, for antisocial symptoms, shared environmental risks also contributed to the stability. Genetic influences on change were observed, but only for antisocial behaviour. In addition, the longitudinal association between antisocial behavioural and later depressive symptoms was also found to be genetically mediated, but this effect was nonsignificant after controlling for stability. Results are discussed in light of the potential contributions of developmental behavioural genetic research in understanding individual differences in the stability and change of maladjustment.

Purpose: Prehospital triage criteria (PTC) have been used to classify patients according to risk of serious injury. This study was conducted determine whether PTC could be used to identify serious injury, the need for intensive care (ICU), or immediate operative intervention (IOI).

Methods: Data for this observational study were gathered prospectively, at a level-I trauma center, from a patient cohort admitted to the trauma service from 01 February to 31 July 1995. Specific triage criteria, based on information given by EMS prior to arrival were used to categorize patients by severity. Patients classified as most serious (codes) had the following: shock, major anatomic injury or proximal penetrating trauma. Patients classified as more serious (alerts) had one of the following: abnormal vital signs, Glasgow Coma Scale <13, moderate anatomic injury, high-risk mechanism of injury, or co-morbid factors. Patients not meeting either set of criteria, but were admitted, served as controls (consults). Injury severity scores (ISS) and probability of survival (Probsurvival) were calculated for each patient. The percentage admitted to the ICU, operating room (OR), or requiring IOI, were tabulated. Statistical analysis was performed using ANOVA, Mest and chi-square.

Purpose: Headache is a very common complaint in emergency medicine. Its causes are myriad, ranging from benign to life-threatening. Patients who access emergency medical services (EMS), often do so after self-assessment has indicated high acuity. We conducted this study to determine if patients transported by EMS with a chief complaint of headache have a higher rate of serious etiology.

Methods: This observational, retrospective study, was conducted by consecutive review of charts on all patients presenting to the emergency department (ED) from December 1994 through May 1995 with a chief complaint of headache. Patients presenting with other manifestations of intracranial pathology (ICP), such as altered mental status or seizures, were excluded. Mode of arrival was determined to be either via emergency medical services (EMS) or other means. Patients were categorized as having serious (meningitis, hemorrhage, tumor) or benign (migraine, etc.) ICP, based final diagnosis. It was noted whether or not diagnostic studies (DS), such as CT scan and lumbar puncture, were performed. Statistical analysis was performed using the Yates corrected chi-square test.