Emergency Medical Services Utilization And Interventions By Paramedics During A Blizzard

EMERGENCY MEDICAL SERVICES UTLIZATION AND INTERVENTIONS BY PARAMEDICS DURING A BLIZZARD. Shalom Sokolow (Sponsored by Sandy Bogucki). Department of Emergency Medicine, Yale University, School of Medicine, New Haven, CT. On February 8th, 2013, southern Connecticut was struck by a powerful blizzard. Emergency Medical Services (EMS) crews experienced significantly increased call volume along with increased response and transport times. This study examined which types of EMS calls increased or decreased during the storm and whether paramedics performed more or fewer advanced life support (ALS) interventions. EMS calls were differentiated by call type and analyzed to determine which types increased or decreased significantly during the blizzard. Then electronic patient care reports were searched for interventions by paramedics and analyzed to determine whether calls with interventions increased or decreased. During the storm, average calls per day increased from 196 to 249 (p=0.001). Statistically significant increases (p The findings may suggest that the higher EMS call volume was due to an increase in lower acuity patients without a corresponding increase in higher acuity patients. Planning for future blizzards therefore may best be met with increased staffing of emergency medical technicians without an increase in paramedic personnel or equipment

Managing Crop tradeoffs: A methodology for comparing the water footprint and nutrient density of crops for food system sustainability

Abstract The relationship between human nutrition and the use of available resources to feed the planet's growing population demands greater attention from decision makers at all levels of governance. Indicators with dual environmental sustainability and food and nutrition security goals can encourage and measure progress towards a more sustainable food system. This article proposes a methodology that supports the development of an approach to assess the water footprint of nutrient-dense foods [m3/kg]. It provides a clear explanation of the methodology, and the use of water footprint benchmark data and corresponding United States Department of Agriculture (USDA) nutrient composition data to apply the process. The study analyzed data for 17 grains, roots and tubers, 9 pulses, 10 nuts and seeds, 17 vegetables, and 27 fruits. Of these, fruits and vegetables are 85% of the bottom quartile for water footprint (i.e., highly water efficient) and 100% of the top quartile for nutrient-density (i.e., very nutrient dense). Spinach is a clear winner, with a very high nutrient-density and low water footprint. The article proposes that this approach can help to establish broad typologies to guide decision makers in distinguishing between win-win, win-lose, and lose-lose scenarios of natural resource use and nutrition security. This resource, if considered along with contributing social, environmental, and economic factors (e.g., local tastes, available water resources, soil fertility, local economies) can promote a food system that offers a diverse range of nutrient-dense foods more sustainably

Managing crop tradeoffs: A methodology for comparing the water footprint and nutrient density of crops for food system sustainability

The relationship between human nutrition and the use of available resources to feed the planet's growing population demands greater attention from decision makers at all levels of governance. Indicators with dual environmental sustainability and food and nutrition security goals can encourage and measure progress towards a more sustainable food system. This article proposes a methodology that supports the development of an approach to assess the water footprint of nutrient-dense foods [m3/kg]. It provides a clear explanation of the methodology, and the use of water footprint benchmark data and corresponding United States Department of Agriculture (USDA) nutrient composition data to apply the process. The study analyzed data for 17 grains, roots and tubers, 9 pulses, 10 nuts and seeds, 17 vegetables, and 27 fruits. Of these, fruits and vegetables are 85% of the bottom quartile for water footprint (i.e., highly water efficient) and 100% of the top quartile for nutrient-density (i.e., very nutrient dense). Spinach is a clear winner, with a very high nutrient-density and low water footprint. The article proposes that this approach can help to establish broad typologies to guide decision makers in distinguishing between win-win, win-lose, and lose-lose scenarios of natural resource use and nutrition security. This resource, if considered along with contributing social, environmental, and economic factors (e.g., local tastes, available water resources, soil fertility, local economies) can promote a food system that offers a diverse range of nutrient-dense foods more sustainably

Substrate preference in immature Anisoptera of Lake Douglas

General EcologyAnimals that are subject to predation must evolve strategies to avoid predators or go extinct. Those that lack the physiology to flee at high speed or employ physical defenses usually rely on methods such as burrowing or using camouflage. Dragonfly naiads, unlike their brightly-colored adult counterparts, are dully-colored and usually blend with the sandy lake bottom on which they live. Because they have a cryptic coloration, they show certain preferences and aversions to different substrate types which benefit or inhibit their crypsis. In this experiment, it was found that a group of naiads in the family Libellulidae showed preference for certain substrates over others during different times of day. Overall, Dragonfly naiads preferred cryptic substrate over the non-cryptic substrate, regardless of day or night conditions. Further studies are necessary to determine the cause of crypsis in dragonfly naiads.http://deepblue.lib.umich.edu/bitstream/2027.42/116400/1/Jozlin_Majmudar_Sokolow_2015.pd

Supporting the Critical Administrative Leadership Role of County Directors

With a foot in both the university and local communities, Cooperative Extension county directors have unique opportunities to network, scan opportunities, identify assets, design and market programs, build public support, and solve problems. A survey of the administrative workload, satisfactions, and frustrations of California county directors finds these leadership roles are insufficiently supported. The data suggest the need to 1) alter merit review policies to reward community connections and networking, 2) reinvent university support bureaucracies to treat county directors as valued customers, and 3) reassert a robust vision of county-based Extension at the highest levels of the organization

Consultations des enfants de moins de 16 ans par le médecin généraliste : ressenti et état des lieux des pratiques dans deux secteurs d’Ile-de-France

Introduction : Pediatrics is a proficiency which is common to all general practitioners. During the course of the residency, one does observe that there is some disparity with regard to the training in pediatrics among the residents depending on the internships that they end up choosing. However, all of them will have to deal with children given the medical demography affecting pediatricians which is insufficient in the cities. Our study purports to draw a picture of the medical consultations by general practitioners of children under sixteen years of age and sets out how general practitioners deal with such consultations. Methodology : Quantitative study by sending a sixteen question questionnaire to 44 general practitioners based in Paris XIV and Meudon from June 2015 to October 2015. Results : Our study shows that pediatric practices are very heterogeneous. Doctors who have recently opened their practice appear to form a group that is more homogeneous which includes a large pediatric population and practitioners that are more comfortable with the children. Conclusion : The future medical demography will very likely lead to an increase in pediatric consultations with general practitioners. Solid training, being part of a medical network and practical experience do enable the general practitioner to better deliver care to children.Introduction : La pédiatrie est une compétence commune à tous les médecins généralistes. Lors de leur parcours d’internat, on observe une certaine disparité dans la formation en pédiatrie des internes de médecine générale suivant les stages choisis. Tous pourtant vont devoir prendre en charge des enfants du fait d’une démographie médicale, notamment de pédiatres, insuffisante en ville. Notre étude réalise un état des lieux des consultations des enfants de moins de 16 ans en médecine générale et analyse le ressenti des médecins généralistes face à ces consultations.Méthode : Étude quantitative par envoi d’un questionnaire de seize questions auprès de 44 médecins généralistes de Paris 14ème et de Meudon de juin 2015 à octobre 2015.Résultats : Notre étude montre une large hétérogénéité de la pratique pédiatrique en ville. Les médecins les plus récemment installés semblent former un groupe plus homogène avec une large population pédiatrique et des médecins plus à l’aise avec les enfants.Conclusion : La démographie médicale à venir va probablement entrainer une augmentation des consultations pédiatriques chez le médecin généraliste. Une bonne formation, le travail en réseau, l’expérience acquise sur le terrain permettent au médecin généraliste de mieux appréhender la prise en charge des enfants