Mountain, Militarized: North Korea, Nuclear Tests, and Nature

On 3 September 2017, the earth shifted. Seismic activity registering 6.1 on the Richter scale indicated a major geophysical event had taken place, one strong enough to change the shape of mountains. On that day, North Korea exploded a nuclear device at the Punggye-ri Nuclear Test Site inside Mount Mantap (Figure 1). Estimated to be at least 100 kilotonnes, it was the largest nuclear device detonated by North Korea to date (Figure 2). Satellite pictures from before and after the event provide visual evidence of the test’s power to alter the lay of the land (Figures 3 and 4). The most obvious immediate effect was subsidence over 34 hectares of Mantap’s western slope—indicated by the appearance of bare patches in the mountain’s vegetation after the test—and a resulting loss of one to three meters of the peak’s total elevation. Long-term, Mantap may suffer from “tired mountain syndrome,” in which its weakened geological structure could result (and may have already resulted) in the collapse of the test tunnels and in seepage of radioactive material into the air, soil, and water

The role of sense of coherence in stressor appraisal

According to the transactional theory of stress, cognitive individual differences impact stressor appraisal. Sense of Coherence (SoC) refers to an individual’s generalized perception of environmental stimuli. Individuals with a strong SoC perceive the world as more comprehensible, manageable, and meaningful and may be more likely to appraise work-related stressors as having potential for opportunities (challenges) than for obstructing personal gain (hindrances) or causing harm (threats). This study assessed the role of SoC in the appraisal of work-related stressors as challenges, hindrances, and threats. Although an individual’s SoC remains relatively stable upon reaching adulthood, there is a positive association between age and SoC across the lifespan. This study examined the moderating effect of age on the relationship between SoC and stressor appraisal. Two statistical techniques were applied, with one set of results supporting the hypothesis and the other set revealing significant relationships between stressor appraisal tendencies and the three SoC subdimensions

The Department of Defense and Its Precursors: History, Responsibilities, and Policies (1770s - Present)

The Department of Defense (DoD) is the nation\u27s oldest agency, founded in 1789, and one of the world\u27s largest single landholders, with approximately twenty-eight million acres under its control in the United States, its territories, and in thirty-eight countries. Over the course of nearly two and a half centuries, the DoD has enabled the United States to assert its influence and power on a global scale, with global consequences. Responsible for the military and defensive needs of the United States, the DoD has played a pivotal role in expanding and securing the nation\u27s territorial claims and in spurring many of the technological developments, such as the harnessing of atomic energy, that have come to characterize modern society. Its policies and actions have resulted in tremendous social, political, and environmental change. Although many of these transformations occurred during wartime, the DoD and its precursors have had as much or more environmental impact in times of peace as in times of crisis. That history reveals a relationship with the natural world that is filled with paradox and ambiguity, a relationship that incorporates both environmental destruction and natural regeneration

Nature as Friction: Integrating Clausewitz into Environmental Histories of the Civil War

In late December 1862 Union general Ambrose Burnside developed plans to march across the Rappahannock and execute a massive turning movement against Confederate general Robert E. Lee’s troops entrenched along the southern banks of the river. Burnside hoped to ring in the new year by trapping Lee and his Confederates against the river, capturing his army, and redeeming the recent Union defeat at Fredericksburg. In so doing, he would also establish a strong position for marching against Richmond, the ultimate Union goal. Under ideal conditions, Burnside’s plan was viable, if risky. However, as often happens in war, conditions were nowhere near perfect

From “Drip & Ship” to “Give & Go”: Transitioning from Alteplase to Tenecteplase for Acute Ischemic Stroke

Introduction: Stroke is the leading cause of disability among adults and fifth leading cause of death in the United States The goals of treatment include reducing neurologic injury in order to reduce mortality and long term disability Ischemic stroke patients presenting within 24 hours of symptom onset should be evaluated for pharmacologic and mechanical reperfusion therapy Pharmacologic treatment options identified in the current guidelines recommend intravenous alteplase if a patient meets eligibility criteria F or the first time, the 2019 guidelines identified the option to choose tenecteplase over alteplase in patients eligible to receive mechanical thrombectomy Based on available studies, tenecteplase appears to have similar efficacy and safety, and may be more efficacious than alteplase for patients with large vessel occlusion eligible for IV thrombolysis and mechanical thrombectomy Additional benefits of using tenecteplase include cost savings, a faster time to reconstitute and a shorter time to administer 5 seconds vs 1 minute bolus with 1 hour infusion) By being able to administer the drug more quickly with no infusion, faster patient transport from a satellite site or hospital emergency department to a comprehensive stroke center can occur. Purpose: The Henry Ford Health Stroke Council approved an initiative to assemble a multidisciplinary workgroup to review the literature and develop and execute a workplan for transitioning to tenecteplase ( for acute ischemic stroke ( across the organization (all five hospitals and five satellite emergency departments). Organizational Goal: The goal was a successful transition from alteplase to tenecteplase across the organization on June 28 2023 as evidenced by decreased door to needle times, decreased door in door out times, equal outcomes, similar or lower complication rates, and decreased costs. Methods: One year before the planned practice change, the multidisciplinary team began meeting monthly. A workplan was developed with 32 “buckets identified to be addressed for a successful transition to tenecteplase. An “owner was assigned to buckets within their scope of practice The buckets included tasks in these main categories: approvals required from system councils/committees, communications to various affected groups, legal/risk review, Epic builds needed, education and training plan development for nurses, providers, pharmacists and EMS partners, policy/document revisions, and the repackaging plan for a TNK kit. At every meeting, owners reported out completed tasks and barriers encountered in each bucket. Activities accomplished included: • Approval obtained from the ED Pharmacy Taskforce, Anticoagulation Subcommittee, System Drug Use Policy Committee, ED Clinical Council, Medication Management Committee, HF Stroke Council, System Nurse Practice and HFH Combined Nurse Education Council • Epic builds created for TNK in templates, MAR and order sets • Review and update of all policies and documents for verbiage containing alteplase and/or r tPA • Design, development, and deployment of the TNK kit with dosing card • Competency Skill Checklists developed for Preparation and Administration of Tenecteplase • HF University education/training module developed for nurses and pharmacists and a video for neurology and ED residents • Communications with resource list emailed to all Henry Ford Health neurology, emergency medicine and hospitalist providers • OneHenry page created for compiling TNK Transition resources and information Conclusions: On June 28 2023 at 8 00 am, the change from alteplase to tenecteplase for AIS occurred across Henry Ford Health. The first dose of TNK was given that evening at Henry Ford Jackson ED, with Henry Ford Wyandotte ED coming in second the next day. Overall, the transition was incredibly smooth. Preparation and participation from all areas in the planning and rollout were keys to this successful change in practice. We will continue to track the data in several areas. Some of the trends we have already observed: • $159,372 cost savings in first 2 months projections at this rate would be a cost savings of$956,232 over 12 months. • An increase in revascularization in patients with large vessel occlusions ( who received TNK therefore not requiring thrombectomy. • Faster Door In Door Out times for patients transferred for thrombectomy post IV TNK administration. Acknowledgements: We appreciate the support from the leadership teams at each site, the Epic builders and all the nurses, pharmacists and providers who made this a successful transition. Also, Diane Staif, whose expertise was instrumental in creating the nursing education module.https://scholarlycommons.henryford.com/nursresconf2023/1008/thumbnail.jp

Challenge, Hindrance, and Threat Stressors: A Within- and Between-Persons Examination of General and Specific Stressor Appraisal Tendencies and A Priori Categorizations

Within the occupational stress literature, researchers have often identified stressors as being inherently challenging or hindering, based on previous classifications or on the outcomes usually associated with each. Although the challenge-hindrance model is based on the transactional theory of stress (Lazarus & Folkman, 1984), which emphasizes the importance of an individual’s cognitive appraisal of stimuli, much of the research on this framework has failed to measure an individual’s direct appraisal of stimuli in the environment as challenging, hindering, and threatening, which can be problematic when attempting to understand and predict occupational stress. In the present study we identify and share a taxonomy of common workplace stressors, contrast actual appraisal patterns with how researchers in this area tend to position each stressor, and reveal the pattern of appraisal tendencies associated with each of the 17 stressors. The results indicate that a priori classifications of stressors are not always accurate between or within individuals. We discuss implications for future research, which include re-evaluating a priori classifications, measuring appraisals, understanding complex stressors, and the possibility of appraisal tendencies.https://scholar.utc.edu/iopsy/1003/thumbnail.jp

U.S. Multinational Services Companies: Effects of Foreign Affiliate Activity on U.S. Employment

This working paper examines the effect that U.S. services firms’ establishment abroad has on domestic employment. Whereas many papers have explored the employment effects of foreign direct investment in manufacturing, few have explored the effects of services investment. We find that services multinationals’ activities abroad increase U.S. employment by promoting intrafirm exports from parent firms to their foreign affiliates. These exports support jobs at the parents’ headquarters and throughout their U.S. supply chains. Our findings are principally based on economic research and econometric analysis performed by Commission staff, services trade and investment data published by the Bureau of Economic Analysis, and employment data collected by the Bureau of Labor Statistics. In the aggregate, we find that services activities abroad support nearly 700,000 U.S. jobs. Case studies of U.S. multinationals in the banking, computer, logistics, and retail industries provide the global dimensions of U.S. MNC operations and identify domestic employment effects associated with foreign affiliate activity in each industry

Distribution of the birds of the Philippines: biogeography and conservation priorities

The Philippine islands hold a concentration of species diversity and endemism of global importance, yet few studies have analyzed biogeographic patterns or attempted to prioritize areas for conservation within the archipelago. We analyzed distributions of 386 species on 28 Philippine islands and island groups, documenting intense concentration of species richness, especially of endemic species, on the two largest islands, Mindanao and Luzon. Factors identified as influencing species richness included island area, maximum elevation, and Pleistocene patterns of connection and isolation. Reserve systems were developed based on heuristic complementarity algorithms, and compared with the existing Integrated Protected Areas (IPAS) system in the country, showing that IPAS is an impressive first step towards protecting avian diversity in the country. Addition of presently proposed reserves on Palawan and Mindoro would make IPAS a near-optimal reserve design, at least at the level of island representation. Important challenges remain, however, with regard to design of reserve systems within islands to represent complete island avifaunas