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Assessment of community hospital disaster preparedness in New York State
No full textObjective: The intent of this study was to assess disaster preparedness in community hospitals across New York. Design: Descriptive and analytical cross-sectional survey study. The survey instrument consisted of 35 questions that examined six elements of disaster preparedness: disaster plan development, onsite surge capacity, available materials and resources, disaster education and training, disaster preparedness funding levels, and perception of disaster preparedness. Setting: Community hospitals in New York. Subjects: Contact information was obtained for 207 of 208 community hospitals. Email invitations to participate in the survey were sent to hospital CEOs and disaster preparedness coordinators. Completed surveys were received from 80 hospitals. Main Outcome Measures: Hospital responses to questions related to the six elements of disaster preparedness. Results: Most (87.5 percent) hospitals had experienced a disaster event during the past 5 years (2012-2016). Eighty percent had disaster plans that addressed all of six major types of disasters. Only 17.5 percent believed their disaster plans were “very sufficient” and did not require any revisions. Nearly three-quarters (73.3 percent) of hospitals could continue operations for less than a week without external resources. Less than half (49.4 percent) reported being satisfied or very satisfied with the level of funding that they received from the Hospital Preparedness Program. Most (88.8 percent) respondents felt that barriers to disaster preparedness exist for their organizations. Conclusions: The results demonstrate the current level of disaster preparedness among New York hospitals. The study\u27s approach is discussed as a model that will enable hospitals to identify focus areas for improvement and opportunities for legislation and advocacy
Differential Family Experience of Palliative Sedation Therapy in Specialized Palliative or Critical Care Units
No full textContext: No study has examined the varying family experience of palliative sedation therapy (PST) for terminally ill patients in different settings. Objectives: To examine and compare family concerns about PST use and its effect on the grief suffered by terminally ill patients’ families in palliative care units (PCUs) or intensive care units (ICUs). Methods: A total of 154 family members of such patients were recruited in Taiwan, of whom 143 completed the study, with 81 from the PCU and 62 from the ICU. Data were collected on their concerns regarding PST during recruitment. Grief levels were assessed at three days and one month after the patient\u27s death with the Texas Revised Inventory of Grief. Results: Families’ major concern about sedated patients in the PCU was that “there might be other ways to relieve symptoms” (90.2%), whereas families of ICU sedated patients gave the highest ratings to “feeling they still had something more to do” (93.55%), and “the patient\u27s sleeping condition was not dignified” (93.55%). Family members recruited from the ICU tended to experience more grief than those from the PCU (P = 0.005 at Day 3 and \u3c 0.001 at Month 1). PST use predicted higher levels of grief in family members recruited from the PCU (P \u3c 0.001 at Day 3 and Month 1). Conclusion: Family experiences with the use of PST in terminally ill patients varied in different settings. Supportive care should address family concerns about PST use, and regular attention should be paid to the grief of individuals at higher risk
Contemplation and the suffering earth: Thomas merton, pope francis, and the next generation
No full textDuring his address to the US Congress in 2015, Pope Francis lifted up the Trappist monk and famed spiritual writer Thomas Merton as one of four great Americans who offer us a way of seeing and interpreting reality that is life-giving and brings hope. Drawing from Merton and gesturing to Pope Francis\u27s 2015 encyclical Laudato Si\u27, the author explores the epistemological roots of the environmental crisis, arguing that while intellectual conversion to the crisis is crucial, Merton\u27s witness suggests a deeper kind of transformation is required. Reading Merton schools the imagination in the way of wisdom, or sapientia, a contemplative disposition that senses its kinship with Earth through the eyes of the heart, illuminating what Pope Francis has called an integral ecology. The author considers the impact of two major influences on Merton\u27s thought: The Russian Wisdom school of theology, or sophiology, and French theologian Jacques Ellul, whose 1964 book The Technological Society raises prescient questions about the role of technology in education and spiritual formation. Arguing that our present crisis is both technological and spiritual, epistemological and metaphysical, the author foregrounds Merton\u27s contributions to a sapiential theology and theopoetics while asking how the sciences and humanities might work together more intentionally toward the transformation of the personal and collective human heart
Lateral Corticospinal Tract Damage Correlates With Motor Output in Incomplete Spinal Cord Injury
No full textObjective: To investigate the relationship between spinal cord damage and specific motor function in participants with incomplete spinal cord injury (iSCI). Design: Single-blinded, cross-sectional study design. Setting: University setting research laboratory. Participants: Individuals with chronic cervical iSCI (N=14; 1 woman, 13 men; average age ± SD, 43±12y). Interventions: Not applicable. Main Outcome Measures: Axial T2-weighted magnetic resonance imaging (MRI) of spinal cord damage was performed in 14 participants with iSCI. Each participant\u27s damage was processed for total damage quantification, lateral corticospinal tract (LCST) and gracile fasciculus (GF) analysis. Plantarflexion and knee extension were quantified using an isokinetic dynamometer. Walking ability was assessed using a 6-minute walk test. Results: Total damage was correlated with plantarflexion, knee extension, and distance walked in 6 minutes. Right LCST damage was correlated with right plantarflexion and right knee extension, while left LCST damage was correlated with left-sided measures. Right and left GF damage was not correlated with the motor output measures. Conclusions: MRI measures of spinal cord damage were correlated to motor function, and this measure appears to have spatial specificity to descending tracts, which may offer prognostic value after SCI
Colorado\u27s new proxy law allowing physicians to serve as proxies: Moving from statute to guidelines
No full textIn 2016, the Colorado legislature passed an amendment to Colorado\u27s medical proxy law that established a process for the appointment of a physician to act as proxy decision maker of last resort for an unrepresented patient (Colorado HB 16-1101: Medical Decisions For Unrepresented Patients). The legislative process brought together a diverse set of stakeholders, not all of whom supported the legislation. Following passage of the statutory amendment, the Colorado Collaborative for Unrepresented Patients (CCUP), a group of advocates responsible for initiating the legislative process, coordinated a unique effort to engage these stakeholders in the creation of a set of voluntary guidelines to assist facilities and individual careproviders in the implementation of policies and procedures enabled by the statute. This article delineates the questions and concerns of stakeholders, describes how those issues were addressed within the guidelines, and proposes additional opportunities for research to assess the impact of the legislation in Colorado
Transcranial magnetic stimulation does not improve mild cognitive impairment in Parkinson\u27s disease
No full textSex trafficking and the media: Perspectives from the United States and Thailand
No full textThis book explores how sex trafficking has been reported in the media. The book is set in the context of reportage of this human rights abuse in two varying political landscapes-the United States being a developed democracy and Thailand experiencing continued political turmoil including a May 2014 coup d’état and an accompanying crackdown on free expression by the ruling military junta. In doing so, the book shows how there are great similarities between the two countries in the way the issue is misrepresented. Drawing on content analysis of news coverage in the United States and Thailand as well as interviews with journalists, anti-trafficking advocates, survivors of sex trafficking and consensual sex workers, this book illuminates reasons why coverage is framed in the way(s) that it is, how anti-trafficking advocates can act as media advocates to push coverage in new directions, and how journalistic functions are similar and different in the two countries
Biosocial Criminology Versus the Constitution
Get PDFThe continually emerging field of biosocial criminology provides a basis for productively merging biology with sociological reasonings for criminal behavior. Mainstream research in criminology focuses on environmental factors as the sole reason individuals exhibit antisocial behavior patterns and may ultimately commit crimes. Criminological research has travelled in this direction for decades. The current climate within this community subscribes heavily to the notion that biology has very little to do with why people behave the way they do, and if it did, government control would be the norm. The nature of biocriminology opens a door through which constitutional issues may enter. Conventional criminology envisions a dark side to this aspect where search and seizure and due process questions exist, similar to intrusive issues recognized in early 20th century legislation. Questions of how and when biological samples are collected and from whom suggest the potential for a slippery slope into unreasonable access by the government. Biosocial researchers do not intend this. The purpose of biosocial research can and should enhance traditional criminological theory, thus, potentially offering more realistic solutions to social challenges. Addressing current issues such as crime rates in disadvantaged areas, incarceration and recidivism rates, and challenges that affect the mentally ill, reveals possibilities that may provide intervention by offering viable treatment protocols rather than endless explanations. It is important to create solutions that bypass political or ideological motivations. The goal is to capitalize on this integration in such a way so as not to violate the constitutional rights of the individuals who would receive the most benefit
What Drives Species Richness in Colorado\u27s Alpine Tundra
Get PDFDespite years of research, drivers of vascular plant species richness in Colorado’s alpine tundra habitats are largely unknown. Factors such as slope aspect, Pleistocene glaciation, nutrient levels, latitude and longitude, snow depth, and disturbance have been studied. Despite this research, few patterns have emerged. Research in Colorado has been conducted on a few well studied mountains. Aridity is one factor that has not been well studied but shows promise in explaining species richness. In Patagonia and the Swiss Alps, increasing aridity correlates with higher species richness. Here, a full species assessment was conducted on nine mountains previously under researched or not researched in fell field and dry meadow communities. These nine sites covered the precipitation gradient in Colorado from driest to wettest conditions (425mm-1941mm) found above 3657 meters. We found that the abiotic factors of increased precipitation, substrate pH, rather than aridity offered a better explanation of what drives higher species richness. Additionally, we discuss an ecotone between fell fields and dry meadows that can form between these two communities or where topography creates intermediate communities with conditions and species composition shared by both communities. We define a new addition to alpine vegetation communities, pseudo-fell field. This community develops where environmental conditions are similar to true fell fields and include both traditional fell field species, but the overall species composition is unique to this community. If we are able to more accurately characterize in-situ community types, researchers will better understand Colorado’s alpine environments and how future changes will impact them
MS Environmental Biology Capstone Project
Get PDFDeforestation negatively impacts wildlife populations, specifically through the establishment of forest fragments – the breaking up of forest into small disconnected patches which increases the edge to interior ratio. Forest fragments are either created naturally or by anthropogenic causes. While both exhibit negative impacts on wildlife populations, anthropogenic edges may more negatively impact an animal population’s group size and sex ratio, which are vital to a population’s reproductive success and survival. The purpose of this research project is to gain insight into the effects of both natural and anthropogenic forest edges on white-faced capuchin’s (Cebus capucinus) group size and sex ratio. The research will be conducted at La Suerte Biological Field Station (LSBFS) in Costa Rica, under the guidance of Dr. Amy Schreier. It is hypothesized that vegetation richness and tree diameter at breast height (DBH) are higher in natural edges compared to anthropogenic edges, creating varying levels of food sources and habitat. Therefore, I predict that C. capucinus will have smaller group sizes and less even sex ratios in the anthropogenic edge compared to the natural edge because of the limited DBH and tree species richness present in the anthropogenic edge. I will record the number and sex of individuals in a group within a twenty-meter radius. This research will help to increase the understanding of the negative effects of forest edges and deforestation on animal populations. It will be the first of its kind within this study site and will have implications for conservation globally