Mass Fatality Incidents and the Role of the Dental Hygienist: Are We Prepared?

Dental hygienists can fill critical roles during mass fatality incidents in the area of disaster victim identification, providing much needed support to forensic odontologists. The purpose of this paper is to bring awareness that research is needed to assess current dental hygiene programs, continuing education opportunities and the type of approach being used to develop and implement pedagogy in the forensic specialty area, specifically mass fatality preparedness and response for the dental hygienist. Because of the threat of terrorism in the U.S. and natural disasters like hurricanes, the need to prepare dental professionals in disaster response and fatality management is real. The authors\u27 recommendations are to incorporate training in the areas of risk management and infection control in the mortuary setting, antemortem and postmortem records comparison, safe usage of portable radiographic equipment, and proper radiographic technique for the deceased victim. Disaster victim identification training in these areas is necessary for the accurate, efficient and dignified identification of disaster victims while minimizing errors and increasing responder safety. The dental hygiene professional can assist disaster mortuary response efforts in a way that leverages multidisciplinary teams, if effective training programs are implemented

Surgeons or Scribes? The Role of United States Court of Appeals Law Clerks in Appellate Triage

Using original survey data, we explore how federal courts of appeals judges select and use their law clerks—a question that we answered in an earlier article about federal district court clerks. As with that first article, we do not intend to tackle such normative issues as whether courts of appeals law clerks possess too much influence over the judicial process or whether the selection criteria used by these judges is appropriate. What we will present, however, is descriptive data on the criteria that courts of appeals judges use to pick their law clerks as well as the tasks assigned to those clerks. We believe that our findings, namely, that courts of appeals judges delegate substantial job duties to their clerks, should serve as the springboard for a future debate over the wisdom of such delegation

Surgeons or Scribes? The Role of United States Court of Appeals Law Clerks in Appellate Triage

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Biostratigraphic utility of coiling direction in Miocene planktonic foraminiferal genus Paragloborotalia

Trochospiral planktonic foraminifera will coil either sinistral (left) or dextral (right). The prevalence of sinistral or dextral coiling can change through the stratigraphic range of morphospecies with a preference in coiling direction. A number of coiling shifts have been applied as secondary marker events through the Recent to late Miocene (~0–7 Ma) biochronology. However, no such events have been applied beyond this age despite a number of species being known to adopt preferential coiling directions. Here we investigate selected Miocene species within the genus Paragloborotalia. Previous work in the tropical to subtropical realm has shown that the mayeri–siakensis group undergoes a shift from random to sinistrally dominated coiling in the mid Miocene (~15 Ma). We extend the investigation to other Miocene paragloborotaliids in the low (IODP Sites U1337, U1338, ODP Sites 871 and 925), mid (JOIDES-3 hole) and high latitudes (ODP Site 747) in order to assess whether there is global synchronicity and if the change is unique to the mayeri-siakensis group. In addition, a number of outcrop samples from the Cipero and Lengua formations in southern Trinidad are quantitatively compared to previously published trends. Our results show that in the low-mid latitudes the coiling shift is at ~15.37 Ma within planktonic foraminiferal Zone M5 within both Paragloborotalia siakensis and Paragloborotalia continuosa. In the high latitudes the absence of paragloborotaliids through a portion of the mid Miocene interval prevents accurate dating of a shift from early forms showing random coiling to later paragloborotaliids adopting a sinistral preference. We also find two coiling changes in the genus Globorotalia at high latitude Site 747, from random to sinistral in the mid Miocene (15.14 Ma) and sinistral to dextral (10.02 Ma) in the late Miocene. We propose the recognition of a coiling change in Paragloborotalia as a secondary bioevent in the mid Miocene at 15.37 Ma, and a useful means for the recognition of the base of the Langhian. The coiling shift as a biostratigraphic marker is likely to be particularly useful in regions where the currently applied bioevents, namely the Praeorbulina–Orbulina lineage, is rare or poorly represented

COVID-19 Evacuation and Sheltering Risk Perception Study

First two paragraphs from the Executive Overview: This report, COVID-19 Evacuation and Sheltering Risk Perception Study, is one of several key science-based research efforts produced for the State reflecting the most current knowledge related to evacuation and sheltering behavior. The primary data source for this report are interviews with 2,200 households across ten localities in Hampton Roads, including the Eastern Shore. The findings – and recommendations – within this report are intended to inform and advance state and local evacuation and public shelter planning. This report contains 31 specific recommendations (Action Items) that broadly advance coastal resilience and protect the health and wellbeing of Virginia residents. All citizens benefit from these recommendations; however, these recommendations especially advance the health and wellbeing of medically fragile and vulnerable populations. While progress has been made, disparities in health and wellbeing across Virginian’s populations persist. Expectedly, these differences are likely to be exacerbated by a catastrophic severe weather event, such as a hurricane with wind and surge flooding, during the time of a pandemic. These Action Items, when implemented, may be expected to lessen the disparate impacts of severe weather events, thus addressing issues of equity and social justice

Disaster Preparedness and Response: A Survey of U.S. Dental Hygienists

Purpose: The purpose of this study was to assess dental hygienists’ interests, current involvement, formal education, views, comfort levels, and intentions for involvement with disaster preparedness and response. Methods: Dental hygienists (n=400) were asked to respond to a 21-item online survey. Data was analyzed using descriptive statistics, chi-square goodness-of-fit tests, and a paired-samples t-test. Common themes were identified and categorized from open-ended questions. Results: A response rate of 84% (n=334) was obtained. Most respondents (97%) reported no involvement with disaster preparedness and response; however, a majority (86%) reported interest. Of those who indicated an interest in disaster preparedness and response, 92% had intentions for becoming involved. A majority of dental hygienists (93%) had not received formal education in disaster preparedness and response; yet, 95% shared the view that dental hygienists could have a vital role in this specialty area. Although results indicated a mean difference of 9% increased comfort with activities not requiring physical contact with human remains, dental hygienists were relatively comfortable with activities requiring contact: taking photographs (76%, n=254), taking radiographs (83%, n=273), resecting the mandible (55%, n=184), cleaning skeletonized remains (67%, n=221). Conclusion: Dental hygienists view themselves as professionals who could have a vital role in disaster preparedness and response. Efforts should be made to increase dental hygiene formal education in disaster preparedness and response with needed curriculum models and competencies for best outcomes when dental hygienists are serving their communities

Modeling the Spread of COVID-19 in Spatio-Temporal Context

This study aims to use data provided by the Virginia Department of Public Health to illustrate the changes in trends of the total cases in COVID-19 since they were first recorded in the state. Each of the 93 counties in the state has its COVID-19 dashboard to help inform decision makers and the public of spatial and temporal counts of total cases. Our analysis shows the differences in the relative spread between the counties and compares the evolution in time using Bayesian conditional autoregressive framework. The models are built under the Markov Chain Monte Carlo method and Moran spatial correlations. In addition, Moran\u27s time series modeling techniques were applied to understand the incidence rates. The findings discussed may serve as a template for other studies of similar nature

Testing a Novel 3D Printed Radiographic Imaging Device for Use in Forensic Odontology

There are specific challenges related to forensic dental radiology and difficulties in aligning X-ray equipment to teeth of interest. Researchers used 3D printing to create a new device, the combined holding and aiming device (CHAD), to address the positioning limitations of current dental X-ray devices. Participants (N = 24) used the CHAD, soft dental wax, and a modified external aiming device (MEAD) to determine device preference, radiographer\u27s efficiency, and technique errors. Each participant exposed six X-rays per device for a total of 432 X-rays scored. A significant difference was found at the 0.05 level between the three devices (p = 0.0015), with the MEAD having the least amount of total errors and soft dental wax taking the least amount of time. Total errors were highest when participants used soft dental wax-both the MEAD and the CHAD performed best overall. Further research in forensic dental radiology and use of holding devices is needed

Evacuation Behavior of Households Facing Compound Hurricane-Pandemic Threats

This study examines households\u27 prospective evacuation behavior during a hurricane-pandemic compound threat. Data from a 2020 survey of coastal Virginia households help answer two questions: (1) What factors associated with the threat and impacts of the COVID-19 pandemic and hurricanes influence prospective evacuation behavior of households during a compound hurricane-pandemic event? (2) What are the equity implications for emergency management policies and practices to support evacuation and sheltering during a compound hurricane-pandemic event? Households in the sample were split between those who stated they would evacuate away from the at-risk region and who would stay. Greater household vulnerability to hurricanes and COVID-19 and having sufficient financial resources increase likelihood of evacuation. Higher income households were more likely to have resources to evacuate and less likely to suffer financial consequences from a hurricane or pandemic. Racial minorities are more vulnerable to the pandemic and face greater resource challenges for evacuating

Factors affecting consistency and accuracy in identifying modern macroperforate planktonic foraminifera

Planktonic foraminifera are widely used in biostratigraphic, palaeoceanographic and evolutionary studies, but the strength of many study conclusions could be weakened if taxonomic identifications are not reproducible by different workers. In this study, to assess the relative importance of a range of possible reasons for among-worker disagreement in identification, 100 specimens of 26 species of macroperforate planktonic foraminifera were selected from a core-top site in the subtropical Pacific Ocean. Twenty-three scientists at different career stages – including some with only a few days experience of planktonic foraminifera – were asked to identify each specimen to species level, and to indicate their confidence in each identification. The participants were provided with a species list and had access to additional reference materials. We use generalised linear mixed-effects models to test the relevance of three sets of factors in identification accuracy: participant-level characteristics (including experience), species-level characteristics (including a participant’s knowledge of the species) and specimen-level characteristics (size, confidence in identification). The 19 less experienced scientists achieve a median accuracy of 57 %, which rises to 75 % for specimens they are confident in. For the 4 most experienced participants, overall accuracy is 79 %, rising to 93 % when they are confident. To obtain maximum comparability and ease of analysis, everyone used a standard microscope with only 35× magnification, and each specimen was studied in isolation. Consequently, these data provide a lower limit for an estimate of consistency. Importantly, participants could largely predict whether their identifications were correct or incorrect: their own assessments of specimen-level confidence and of their previous knowledge of species concepts were the strongest predictors of accuracy