In 2002, the World Congress on Drowning developed a uniform definition for drowning. The aim of this study is to determine the prevalence of "non-uniform drowning terminology" (NUDT) and "non-uniform ...drowning definitions" (NUDD) in peer-reviewed scientific literature from 2010 to 2016, and compare these findings with those from our unpublished study performing a similar analysis on literature from 2003 to 2010.
A systematic review was performed using drowning-specific search terms in Pubmed and Web of Science. Titles and abstracts published between July 2010 and January 2016 were screened for relevance to the study focus. Articles meeting screening criteria were reviewed for exclusion criteria to produce the final group of studies. These articles were reviewed by four reviewers for NUDT and NUDD. The Fisher exact test was used to determine any statistically significant changes.
The final group of studies included 167 articles. A total of 53 articles (32%) utilized NUDT, with 100% of these including the term "near drowning". The proportion of articles utilizing NUDT was significantly less than reported by our previous study (p < 0.05). In addition, 32% of the articles included a definition for drowning (uniform or non-uniform), with 15% of these utilizing NUDD.
Our study reveals a statistically significant improvement over the past thirteen years in the use of uniform drowning terminology in peer-reviewed scientific literature, although year-to-year variability over the current study period does not yield an obvious trend.
Of the articles reviewed during the 2010-2016 study period, 32% included outdated and non-uniform drowning terminology and definitions. While this reveals an absolute decrease of 11% as compared with the previous study period (2003-2010), there is still significant room for improvement.
Over the past fifteen years, AP Human Geography has grown in numbers and spread to almost every state. This article synopsizes the early history of the subject, summarizes the course and the exam, ...highlights positive impacts on the discipline of geography, and focuses on the following three issues: teachers who come to the course having majored in other subjects, the large numbers of students taking the exam as ninth graders, and the need to incorporate more geospatial technologies and critical geography into the course outline.
The collapse of Communism in the USSR and Eastern Europe between 1989 and 1991 was followed by a decade of new-found independence for two groups of states: (1) the former Soviet Socialist Republics ...of the USSR, and (2) the former Communist states of Eastern Europe, all but two of which were Soviet satellites. As part of an effort to redefine their character and relative location on the European stage, almost all of these states launched a cartography of independence, putting the world on notice that a new set of geographical realities had taken hold of the region. During the 1990s, maps were requested from each country’s embassy in Washington, DC; 15 of the 19 embassies responded, usually with multiple maps. Using perception theory, communication theory, and semiotic theory, these cartographic artifacts, some of which are presented in this article, were analyzed with the objective of understanding how each country wished to present itself in the post-Communist era. Through the lens of persuasive cartography, we are able to note the nation-building process at work and the emergence not only of newly independent countries but of a new Europe.
This paper describes a process of ‘open’ interdisciplinary scholarship. Researchers from across the University of Oklahoma blogged about a recent paper by ecologist Erle Ellis, and met in person to ...discuss posts. They then hosted Ellis for a seminar on questions that emerged, and for a public panel discussion.
The effect of digestion by a predatory fish (largemouth bass Micropterus salmoides) on stable isotopic (δ13C and δ18O) and trace elemental (Sr:Ca and Ba:Ca) compositions of prey fish (bluegill ...Lepomis macrochirus) otoliths was investigated in a laboratory experiment. Trace element and stable‐isotopic signatures of L. macrochirus otoliths were not significantly altered for up to 16 h after L. macrochirus were consumed by M. salmoides. Prey fish otoliths recovered from predator digesta can retain environmental stable isotopic and trace elemental signatures, suggesting that determination of environmental history for prey fishes by stable‐isotope and trace‐element analysis of otoliths recovered from stomachs of piscivorous fishes will be feasible.
The metabolic effects of high-carbohydrate (70%), high-fiber (70 g) (HCHF) and low-carbohydrate (39%), low-fiber (10 g) (LCLF) diets were examined for 10 subjects with insulin-dependent diabetes ...mellitus (IDDM). After a 1-wk control period subjects on a metabolic ward were randomly allocated to HCHF or LCLF diets for 4 wk. After a 6-wk washout period subjects re-entered the metabolic ward for 4 wk on the alternate diet. Artificial-pancreas studies were performed on each diet for measurement of insulin requirements. Compared with the LCLF diet, the HCHF diet reduced basal insulin requirements (P< 0.025), increased carbohydrate disposed of per unit insulin (P< 0.0008), and lowered total (P< 0.0004) and high-density-lipoprotein cholesterol (P< 0.0013). Glycemic control and other lipid fractions did not differ significantly. These results suggest that in IDDM patients, HCHF diets enhance peripheral glucose disposal, decrease basal insulin requirements, and lower total cholesterol without altering glycemic control or triglycerides.
Background:
While medication reconciliation (MR) has been shown to reduce medication errors by limiting errors of transcription, omission, and duplicate therapy, its Impact on the provision of ...unnecessary prophylaxis is largely unknown.
Objective:
To determine the effect of MR on the incidence of prolonged stress ulcer prophylaxis (SUP) across the continuum of care from hospital admission to discharge as well as evaluate clinical conditions associated with prolonged SUR
Methods:
This retrospective study assessed patients who were admitted to the intensive care unit (ICU) and had SUP initiated. Patients were excluded if they were receiving gastroprotective therapy prior to ICU admission, were being treated for an acute gastrointestinal hemorrhage, or died. The need for SUP was determined using risk factors adapted from evidence-based guidelines developed by the American Society of Health-System Pharmacists. The use of SUP was assessed upon transfer from the ICU to a non-ICU setting and at hospital discharge. Results were compared between pre-MR and post-MR groups.
Results:
Data from 114 (pre-MR, n = 53; post-MR, n = 61) medical and surgical ICU patients were evaluated. There was no significant difference in the use of prolonged SUP upon transfer from the ICU to a non-ICU setting in the pre-MR and post-MR groups, respectively (85% 45/53 vs 79% 48/61), p = 0.393). Similarly, there was no significant difference in the use of prolonged SUP upon hospital discharge In the pre-MR and post-MR groups, respectively (14% 6/44 vs 23% 10743), p = 0.247), There were no clinical conditions for which prolonged SUP use was predominant.
Conclusions:
The strategy of MR alone will not decrease the incidence of prolonged SUP in hospitalized patients. Other techniques should be evaluated to encourage appropriate use of acid-suppressive agents.
The fabrics associated with protective clothing affect heat stress, which influences productivity and risks of heat-related disorders. This study compared the work limiting effects of five protective ...coveralls and a semiclothed condition (t-shirt and shorts). Two fabric characteristics determined from bench tests, moisture vapor transmission rate (MVTR), and air permeability were also examined as possible predictors of ensemble performance. A progressive metabolic rate protocol was used where environmentalconditions (T
db
= 32°C; T
pwb
= 26°C) were held constant while treadmill speed was slowly increased. The limiting metabolic rate to just maintain thermal equilibrium was the critical point. At this point, critical speed and critical metabolic rate were noted and total evaporative resistance was calculated for each ensemble. Five acclimatized subjects wore each of the six clothing conditions in a random order. Statistically significant differences were found among the five protective garments and a semiclothed ensemble for critical treadmill speed (S
crit
), critical metabolic rate (M
crit
), and total evaporative resistance (R
e − t
). The semiclothed condition (S
crit
= 1.77 m/sec; M
crit
= 580 W; R
e−t
= 0.0099 kPa m
2
/W) and ensembles made from spunbonded, melt blown, spunbonded polypropylene (SMS) (1.72 m/sec; 560 W; 0.0135 kPa m
2
/W) and spunbonded polypropylene (1.67 m/sec; 550 W; 0.0126 kPa m
2
/W) were able to support higher work rates than fabrics made from Tyvek 1422-A (a nonwoven spunbonded olefin) (1.48 m/sec; 470 W; 0.0183 kPa m
2
/W) and a microporous film supported by spunbonded polypropylene (1.34 m/sec; 420 W; 0.0231 kPa m
2
/W). A tightly woven polyester ensemble (1.59 m/sec; 510 W; 0.0130 kPa m
2
/W) had intermediate values and was not significantly different from either group. Air permeability was a better predictor of fabric work limiting performance than MVTR. An air permeability on the order of 10,000 L/min cm
2
bar would have little effect on maximum sustainable work.
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