The Rhetorical Art of Risk Assessment: Lessons from Risk Management in Rural and Tribal Communities

Risk assessment, mitigation, and communication rely on data from multiple sources to form a complete understanding of hazards and how to manage them. Experts can use these data to make informed decisions about the nature and extent of risks and inform the public to protect health, the environment, and economic welfare. However, in an effort to objectively make decisions, technical experts and policymakers increasingly rely on quantitative data as the most important determiner of risk, which can alienate the public, limit risk understanding, and delay or miss obvious signals of impending catastrophe. I examine several cases based on my experiences practicing and researching traffic safety, public safety, and technical and professional communication (TPC). The cases include a look at the impact of limited quantitative data in addressing motor vehicle traffic injuries and death in American Indian and rural communities; the challenge of collecting accurate data by first responders and firefighters to better understand and respond to health and physical hazards; and a recent history of failures to prevent airline and aerospace disasters due to an overemphasis on quantifiable data and devaluation of certain kinds of expert knowledge. The results of this study call attention to the weaknesses resulting from a quantitative imperative in risk management and a proposal for renewed focus on risk assessment using rhetorical practices and qualitative data readily available from expert and non-expert perspectives

Diet Prasejarah Masyarakat Pada Zaman Akhir Pleistosen Akhir Hingga Holosen Di Sarawak Dan Sabah Dari Perspektif Arkeozoologi

Penyelidikan ini memfokuskan kepada sisa fauna vertebrata dari lapisan kebudayaan akhir Pleistosen Akhir hingga Holosen iaitu merangkumi sampel berusia 32,600±210 BP hingga 2,000 BP di Sarawak dan Sabah. Sampel arkeozoologi yang dianalisis adalah dari hasil ekskavasi terbaru (Gua Kain Hitam B, Bukit Tengkorak, Bukit Kamiri dan Melanta Tutup) dan ekskavasi terdahulu (Lobang Angus, Gua Sireh, Agop Atas, Agop Sarapad, Hagop Bilo dan Pulau Balambangan) dari tapak di Sarawak dan Sabah. Tujuan kajian ialah untuk menyelesaikan isu, masalah dan persoalan-persoalan yang mencakupi a) spesies fauna vertebrata dan diet prasejarah, b) aktiviti subsisten dan adaptasi, c) strategi dan amalan memburu dan d) modifikasi sisa fauna. Metod yang diaplikasi melibatkan kerja lapangan (persampelan, konservasi dan analisis lapangan), analisis makmal (konservasi, anatomi, taksonomi dan tafonomi) dan analisis statistik (TNF, NISP dan MNI). Data-data tersebut digabungkan untuk membentuk interpretasi mengenai diet prasejarah dari perspektif arkeozoologi. Hasil analisis anatomi dan taksonomi menunjukkan pelbagai spesies haiwan dikenalpasti wujud dan telah dieksploitasi sebagai sumber diet pada zaman akhir Pleistosen Akhir hingga Holosen. Contohnya, primat (Orang-Utan Pongo pygmaeus), roden (landak Hystrix brachyura), karnivor (musang Paradoxurus sp.), Pholidota (tenggiling Manis javanica), Perissodactyla (badak Rhinoceros sondaicus), Artiodactyla (rusa Cervus sp.), unggas (ayam hutan Gallus sp. dan helang Spizeatus sp.), reptilia (Geoemydidae, Trionychidae dan Cheloniidae) dan ikan air tawar serta ikan marin

A newborn with diabetic ketoacidosis and thalassemia major: A rare case

Diabetic ketoacidosis is a systemic situation caused byabsolute insulin deficiency and characterized by hyperglycemia,ketonemia, acidemia, glycosuria and ketonuria.Thalassemia Major is a very serious hereditary blooddisorder due to low levels or absence of “beta globulin”chain, characterized by requiring a blood transfusion from3-4. month of life due to the relatively short life of red cells.We, herein presented a rare case of 20 day-old newbornwith anemia, hyperglycemia, vomiting, acidosis being diagnosedas thalassemia major that required blood transfusionin the early period of life and diabetic ketoacidosiswithout ketonuria who born from 24 year old father carrierof thalassemia and 23-year-old mother with carrier of thalassemiaand gestational diabetes.The case was presented in order to emphasize that diabeticketoacidosis can occur in newborns without ketonuriaand thalassemia major may cause anemia in the earlyperiod of life due to hyperglycemia and acidosis

Residents and interns in the 3 university hospitals: their knowledge of and attitudes to drug allergy

Background: Previous studies revealed there are many gaps in the awareness and knowledge regarding the diagnosis and management of drug allergy (DA) among various health-care professionals. Objective: To assess the knowledge, attitudes, and practices towards DA among residents and interns of 3 university hospitals in the region of Trakya (Thrace), Turkey. Methods: A cross-sectional survey was conducted at university hospitals of 3 cities in the Trakya region: 1. Trakya University Medical Faculty, Edirne (n = 405), 2. Namik Kemal University Medical Faculty, Tekirdag (n = 114), and 3. Canakkale 18 Mart University Medical Faculty, Canakkale (n = 111). A Turkish questionnaire was developed based on previous published studies. Results: The majority of participants (67%) had not received education on DA as a separate subject during their medical education. Less than a third (28.3%) of all respondents were satisfied with their knowledge concerning patients with clinical signs of DA. Of the 6 knowledge questions on DA, the average score for the study was 3.51 out of 6 (58.5%). Residents had a higher knowledge score (3.93 +/- 1.1) compared with interns (3.05 +/- 1.2) (p < 0.001). The lowest percentage of correct answers were in response to questions on laboratory confirmation of drug-related anaphylaxis (14.5%) and the possibility of penicillin toleration in patients with a history of penicillin allergy (11.8%). The majority of participants (92%) believe that medical doctors should be educated in DA. There were no significant correlations between taking DA histories and the frequency during daily practice of encountering patients. Conclusion: Our study revealed that DA knowledge and attitudes are not at satisfactory level among respondents, and we concluded the importance and necessity of reinforcement of DA education in pre- and postgraduate education of medical doctors

Hypogammaglobulinemia Prevelance in Children with Atopic Dermatitis and the Relationship Between Immunoglobulin Levels and Eczema Severity

Aim:Atopic dermatitis (AD) is the most common chronic skin disease of childhood. Although eczema may be a prominent finding in some primary immune deficiencies, there are very few studies conducted on the frequency of hypogammaglobulinemia in patients with eczema. In our study, we aimed to determine the frequency of hypogammaglobulinemia in patients with AD and the relationship between immunoglobulin levels and eczema severity.Materials and Methods:Patients between the ages of 0-18 years, who were diagnosed with AD between January 2015 and August 2018 in the Department Pediatrics Division of Pediatric Allergy and Immunology, Trakya University Faculty of Medicine, were included in the study. Hypogammaglobulinemia was defined as being less than -2 standard deviation of immunoglobulin A, M and G from normal values for age.Results:The median age of 117 patients included in the study was 11 months [interquartile range (IQR): 6.7-33 months], the median age of eczema onset was 3.5 months (IQR: 2-6 months), the median SCORingAtopicDermatitis at presentation was 13.8 (IQR): 5-32]. Thirty-six (30.8%) patients had low levels in one of the immunoglobulin isotypes and decreased levels of immunoglobulin A (IgA), M and G were found in 21 (17.9%), 18 (15.5%) and 23 (19.7%) patients, respectively. While there was no difference between mild and moderate-severe eczema groups in terms of age at presentation, age of onset of eczema, family history of allergic diseases, smoking exposure, aeroallergen sensitivity, food allergy, the number of patients having hypogammaglobulinemia, and the levels of IgA, M and G, a male predominance and higher number of eosinophils were observed in the moderate-severe eczema group.Conclusion:It is concluded that the evaluation of immunoglobulin levels independent of the severity of eczema is important for the distinction of primary immunodeficiency and the follow-up of patients in terms of transient hypogammaglobulinemia of infancy in patients with AD

Analisis awalan sisa-sisa cangkerang moluska prasejarah akhir di Melanta Tutup dan Bukit Kamiri, Semporna, Sabah

Tapak arkeologi Melanta Tutup dan Bukit Kamiri di Semporna, Sabah, Malaysia telah diekskavasi oleh Pusat Penyelidikan Arkeologi Global, Universiti Sains Malaysia dengan kerjasama Jabatan Muzium Sabah serta Jabatan Warisan Negara pada tahun 2003, 2004, 2006 dan 2007. Hasil ekskavasi telah mendedahkan penemuan seperti bukti pengebumian, alat batu, pecahan tembikar tanah liat, artifak logam dan tinggalan sisa-sisa fauna yang terdiri daripada spesies vertebrata dan invertebrata. Fokus perbincangan adalah sisa-sisa cangkerang moluska yang berasosiasi dengan lapisan kebudayaan prasejarah akhir (Zaman Logam) yang berusia sekitar 1,380 SM – 1,170 M di Melanta Tutup dan 1,380 – 760 SM di Bukit Kamiri. Berdasarkan analisis arkeozoologi, sisa-sisa cangkerang moluska yang dieksploitasi adalah dari kelas Gastropoda (Neritidae, Potamididae, Pachychilidae, Thiaridae, Trochidae, Muricidae dan Strombidae) dan Bivalvia (Arcidae, Cyrenidae dan Veneridae). Hal ini menunjukkan bahawa subsisten masyarakat prasejarah akhir Melanta Tutup dan Bukit Kamiri merangkumi persekitaran dari sumber marin, paya bakau dan air tawar. Sisa-sisa cangkerang moluska bukan sahaja sebagai bukti diet malahan berfungsi sebagai kiriman pengebumian berdasarkan asosiasinya dengan rangka manusia

Community Engagement in a Graduate-Level Community Literacy Course

A case study of a graduate-level community literacy seminar that involved a tutoring project with adult digital literacy learners, this essay illustrates the value of community outreach and service-learning for graduate students in writing studies. Presenting multiple perspectives through critical reflection, student authors describe how their experiences contextualized, enhanced, and complicated their theoretical knowledge of public rhetoric and community literacy. Inspired by her students’ reflections, the faculty co-author issues a call to graduate programs in writing, rhetoric, literacy studies, and technical communication to develop a conscious commitment to graduate students’ civic engagement by supporting opportunities to learn, teach, and research with community partners

Effects of Storage Temperature and Time on Stability of Serum Tacrolimus and Cyclosporine A Levels in Whole Blood by LC-MS/MS

Tacrolimus and cyclosporine A are immunosuppressant drugs with narrow therapeutic windows. The aim of this study was to investigate the stability of tacrolimus and cyclosporin A levels in whole blood samples under different storage conditions. Whole blood samples were obtained from 15 patients receiving tacrolimus and 15 patients receiving cyclosporine A. Samples were immediately analyzed and then stored at different conditions (room temperature (24°C−26°C) for 24 hours, +4°C for 24 and 48 hours, and −20°C for one month) and then analyzed again. For tacrolimus, there was a significant difference between samples analyzed immediately and those kept 24 hours at room temperature (P=0.005) (percent change 32.89%). However, there were no significant differences between the other groups. For cyclosporine A, there was a significant difference between samples analyzed immediately and those kept 24 hours (P=0.003) (percent change 19.47%) and 48 hours (P=0.002) (percent change 15.38%) at +4°C and those kept 24 hours at room temperature (P=0.011) (percent change 9.71%). Samples of tacrolimus should be analyzed immediately or stored at either +4°C or −20°C, while samples of cyclosporine A should be analyzed immediately or stored at −20°C