Evaluating LANDSAT-4 MSS and TM data

Interband line pixel misregistrations were determined for the four MSS bands of the Mistassini, Ontario scene and multitemporal registration of LANDSAT-4 products were tested for two different geocoded scenes. Line and pixel misregistrations are tabulated as determined by the manual ground control points and the digital band to band correlation techniques. A method was developed for determining the spectral information content of TM images for forestry applications

Microbiology and atmospheric processes: Biological, physical and chemical characterization of aerosol particles

The interest in bioaerosols has traditionally been linked to health hazards for humans, animals and plants. However, several components of bioaerosols exhibit physical properties of great significance for cloud processes, such as ice nucleation and cloud condensation. To gain a better understanding of their influence on climate, it is therefore important to determine the composition, concentration, seasonal fluctuation, regional diversity and evolution of bioaerosols. In this paper, we will review briefly the existing techniques for detection, quantification, physical and chemical analysis of biological particles, attempting to bridge physical, chemical and biological methods for analysis of biological particles and integrate them with aerosol sampling techniques. We will also explore some emerging spectroscopy techniques for bulk and single-particle analysis that have potential for in-situ physical and chemical analysis. Lastly, we will outline open questions and further desired capabilities (e. g., in-situ, sensitive, both broad and selective, on-line, time-resolved, rapid, versatile, cost-effective techniques) required prior to comprehensive understanding of chemical and physical characterization of bioaerosols

Fluorescent Excitation of Spectral Lines in Planetary Nebulae

Fluorescent excitation of spectral lines is demonstrated as a function of temperature-luminosity and the distance of the emitting region from the central stars of planetary nebulae. The electron densities and temperatures are determined, and the method is exemplified through a detailed analysis of spectral observations of a high excitation PN, NGC 6741, observed by Hyung and Aller(1997). Fluorescence should also be important in the determination of element abundances. It is suggested that the method could be generally applied to determine or constrain the luminosity and the region of spectral emission in other intensively radiative sources such as novae, supernovae, and active galactic nuclei.Comment: 5 pages, 4 figures (fig.4 in color), ApJ (in press

Which patients should be transported to the emergency department? A perpetual prehospital dilemma

Objective: To examine the ability of paramedics to identify patients who could be managed in the community and to identify predictors that could be used to accurately identify patients who should be transported to EDs. Methods: Lower acuity patients who were assessed by paramedics in the Perth metropolitan area in 2013 were studied. Paramedics prospectively indicated on the patient care record if they considered that the patient could be treated in the community. The paramedic decisions were compared with actual disposition from the ED (discharge and admission), and the occurrence of subsequent events (ambulance request, ED visit, admission and death) for discharged patients at the scene was investigated. Decision tree analysis was used to identify predictors that were associated with hospital admission. Results: In total, 57183 patients were transported to the ED, and 10204 patients were discharged at the scene by paramedics. Paramedics identified 2717 patients who could potentially be treated in the community among those who were transported to the ED. Of these, 1455 patients (53.6%) were admitted to hospital. For patients discharged at the scene, those who were indicated as suitable for community care were more likely to experience subsequent events than those who were not. The decision tree found that two predictors (age and aetiology) were associated with hospital admission. Overall discriminative power of the decision tree was poor; the area under the receiver operating characteristic curve was 0.686. Conclusion: Lower acuity patients who could be treated in the community were not accurately identified by paramedics. This process requires further evaluation. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine

Evidence-based paramedic models of care to reduce unnecessary emergency department attendance – feasibility and safety

Background: As demand for Emergency Department (ED) services continues to exceed increases explained by population growth, strategies to reduce ED presentations are being explored. The concept of ambulance paramedics providing an alternative model of care to the current default ‘see and transport to ED’ has intuitive appeal and has been implemented in several locations around the world. The premise is that for certain noncritical ill patients, the Extended Care Paramedic (ECP) can either ‘see and treat’ or ‘see and refer’ to another primary or community care practitioner, rather than transport to hospital. However, there has been little rigorous investigation of which types of patients can be safely identified and managed in the community, or the impact of ECPs on ED attendance.Methods/Design: St John Ambulance Western Australia paramedics will indicate on the electronic patient care record (e-PCR) of patients attended in the Perth metropolitan area if they consider them to be suitable to be managed in the community. ‘Follow-up’ will examine these patients using ED data to determine the patient’s disposition from the ED. A clinical panel will then develop a protocol to identify those patients who can be safely managed in the community. Paramedics will then assess patients against the derived ECP protocols and identify those deemed suitable to ‘see and treat’ or ‘see and refer’. The ED disposition (and other clinical outcomes) of these ‘ECP protocol identified’ patients will enable us to assess whether it would have been appropriate to manage these patients in the community. We will also ‘track’ re-presentations to EDs within seven days of the initial presentation. This is a ‘virtual experiment’ with no direct involvement of patients or changes in clinical practice. A systems modelling approach will be used to assess the likely impact on ED crowding.Discussion: To date the efficacy, cost-effectiveness and safety of alternative community-based models of emergency care have not been rigorously investigated. This study will inform the development of ECP protocols through the identification of types of patient presentation that can be considered both safe and appropriate for paramedics to manage in the community

Symptoms and feelings valued by patients after a percutaneous coronary intervention: A discrete-choice experiment to inform development of a new patient-reported outcome

Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective To inform the development of a patient-reported outcome measure, the aim of this study was to identify which symptoms and feelings following percutaneous coronary intervention (PCI) are most important to patients. Design Discrete-choice experiment consisting of two hypothetical scenarios of 10 symptoms and feelings (pain or discomfort; shortness of breath; concern/worry about heart problems; tiredness; confidence to do usual activities; ability to do usual activities; happiness; sleep disturbance; dizziness or light-headedness and bruising) experienced after PCI, described by three levels (never, some of the time, most of the time). Preference weights were estimated using a conditional logit model. Setting Four Australian public hospitals that contribute to the Victorian Cardiac Outcomes Registry (VCOR) and a private insurer's claim database. Participants 138 people aged >18 years who had undergone a PCI in the previous 6 months. Main outcome measures Patient preferences via trade-offs between 10 feelings and symptoms. Results Of the 138 individuals recruited, 129 (93%) completed all 16 choice sets. Conditional logit parameter estimates were mostly monotonic (eg, moving to worse levels for each individual symptom and feeling made the option less attractive). When comparing the magnitude of the coefficients (based on the coefficient of the worst level relative to best level in each item), feeling unhappy was the symptom or feeling that most influenced perception of a least-preferred PCI outcome (OR 0.42, 95% CI 0.34 to 0.51, p<0.0001) and the least influential was bruising (OR 0.81, 95% CI 0.67 to 0.99, p=0.04). Conclusion This study provides new insights into how patients value symptoms and feelings they experience following a PCI

Family systems and mental health issues: A resilience approach

In many cases the consumers of mental health information and support are the families of mental health sufferers. The aim of the project was to understand resilience in people who live with or support a family member with a diagnosed or undiagnosed mental illness. Participants were 15 carers (one male, 14 female). Semi-structured interviews were transcribed and analysed using content analysis. Eight recurring themes emerged which indicated the challenges the carers faced and provided indications of the positive and negative personal, family and social factors that impacted on their lives. These themes were \u27Getting to CLAN WA\u27, \u27Accessing help including CLAN WA\u27, \u27Impact of living with a person who has a mental illness or problematic behaviour\u27, \u27Family and cultural issues\u27, \u27Communication within the family\u27,\u27Coping strategies and evidence of resilience\u27, \u27Social support\u27 and \u27Notion of sacrifice\u27. There is still considerable work to do in supporting people who live with or support a family member in these circumstances. The findings demonstrate that individuals living with adversity can do more than just survive the proces

Floods and health in Gambella region, Ethiopia: a qualitative assessment of the strengths and weaknesses of coping mechanisms

BACKGROUND: Floods are the most frequent and devastating type of natural disaster worldwide, causing unprecedented deaths, diseases, and destruction of property and crops. Flooding has a greater impact in developing countries due to lack of sufficient disaster management structures and a lack of economic resources. OBJECTIVE: This study was conducted with the aim of contributing to the knowledge base of development strategies that reduce flood-related health risks in developing countries. The study focused particularly on assessing the flood risks and health-related issues in the Gambella region of Ethiopia; with the intent of producing relevant information to assist with the improvements in the efficacy of the current flood coping strategies in the region. METHODS: Data were gathered through interviews with 14 officers from different government and non-governmental organizations and a questionnaire survey given to 35 flood victims in Itang woreda. A qualitative approach was applied and the data were analyzed using content analysis. RESULTS: It was found that flooding is a common problem in Gambella region. The findings also indicate that the flood frequency and magnitude has increased rapidly during the last decade. The increase in floods was driven mainly by climate change and changes in land use, specifically deforestation. The reported main impacts of flooding on human health in Gambella region were deaths, injuries, and diseases such as malaria and diarrhea. Another notable consequence of flooding was crop destruction and subsequent malnutrition. CONCLUSIONS: Three weaknesses that were identified in the current coping strategies for flood-related health impacts in Gambella region were a lack of flood-specific policy, absence of risk assessment, and weak institutional capacity. This study recommends new policy approaches that will increase the effectiveness of the current flood coping strategies to sustainably address the impact of flooding on human health