A State and Territorial Survey Regarding Utilization of Environmental Health Shelter Assessments during Disasters, and a Secondary Analysis of Available Shelter Assessment Data

Disasters are complex events characterized by damage to key infrastructure and population displacements into disaster shelters. Assessing the living environment in shelters during disasters is a crucial health security concern. Until now, jurisdictional knowledge and preparedness on those assessment methods, or deficiencies found in shelters is limited. A cross-sectional survey (STUSA survey) ascertained knowledge and preparedness for those assessments in all 50 states, DC, and 5 US territories. Descriptive analysis of overall knowledge and preparedness was performed. Fisher’s exact statistics analyzed differences between two groups: jurisdiction type and population size. Two logistic regression models analyzed earthquakes and hurricane risks as predictors of knowledge and preparedness. A convenience sample of state shelter assessments records (n=116) was analyzed to describe environmental health deficiencies found during selected events. Overall, 55 (98%) of jurisdictions responded (states and territories) and appeared to be knowledgeable of these assessments (states 92%, territories 100%, p = 1.000), and engaged in disaster planning with shelter partners (states 96%, territories 83%, p = 0.564). Few had shelter assessment procedures (states 53%, territories 50%, p = 1.000); or training in disaster shelter assessments (states 41%, 60% territories, p = 0.638). Knowledge or preparedness was not predicted by disaster risks, population size, and jurisdiction type in neither model. Knowledge: hurricane (Adjusted OR 0.69, 95% C.I. 0.06-7.88); earthquake (OR 0.82, 95% C.I. 0.17-4.06); and both risks (OR 1.44, 95% C.I. 0.24-8.63); preparedness model: hurricane (OR 1.91, 95% C.I. 0.06-20.69); earthquake (OR 0.47, 95% C.I. 0.7-3.17); and both risks (OR 0.50, 95% C.I. 0.06-3.94). Environmental health deficiencies documented in shelter assessments occurred mostly in: sanitation (30%); facility (17%); food (15%); and sleeping areas (12%); and during ice storms and tornadoes. More research is needed in the area of environmental health assessments of disaster shelters, particularly, in those areas that may provide better insight into the living environment of all shelter occupants and potential effects in disaster morbidity and mortality. Also, to evaluate the effectiveness and usefulness of these assessments methods and the data available on environmental health deficiencies in risk management to protect those at greater risk in shelter facilities during disasters.

A view, different proposals: Concept of gender and public policy

This article analyzes the meaning of “gender” as a category of analysis in public policy. The concept has been transferred from the feminist theories and this has meant that the United Nations and European Union have incorporated the inequality as a structural inequality and an issue justice. So, the feminist demands enter the political agenda as an integral project which is characterized by the adoption of the gender perspective and its application from a transversal methodology (“gender mainstreaming”). In this sense, the "gender ideology" is a new paradigm against the “patriarchal ideology”. Now, political actions should be articulated in a double movement of correction and promotion to achieve real equality in societies more democratic and ultimately more just.

La lectura como actividad de ocio en escolares asturianos de 6º de primaria

Este trabajo analiza los resultados de una investigación sobre hábitos lectores del alumnado asturiano de 6º de Educación Primaria en su tiempo libre. El estudio utiliza una muestra de 324 escolares de centros públicos urbanos, con edades comprendidas entre los 11 y 12 años, para analizar datos relativos a la actitud hacia la lectura, la importancia de ésta entre las actividades de ocio y la frecuencia lectora.Más de la mitad de los escolares manifiesta una actitud bastante favorable hacia la lectura, y ésta es una de sus actividades de ocio habituales, aunque dedican más tiempo a ver televisión, practicar deportes, usar el ordenador y escuchar música. La mayoría son lectores frecuentes, aunque los no lectores y lectores ocasionales ascienden hasta un 12,96%. Los escolares encuestados leen principalmente libros, seguidos de revistas y cómics, mientras que poco más de un tercio dice leer periódicos frecuentemente.Esta investigación revela también algunas variaciones en actitud hacia la lectura y frecuencia lectora según el centro educativo de procedencia que se pueden relacionar con variables de tipo socio-económico. Además, se observan diferencias entre niños y niñas, pues éstas superan a sus compañeros varones en interés y frecuencia lectora, además de manifestar también divergencias en las preferencias de materiales de lectura.

Multicenter randomized phase II clinical trial comparing neoadjuvant oxaliplatin, capecitabine, and preoperative radiotherapy with or without cetuximab followed by total mesorectal excision in patients with high-risk rectal cancer (EXPERT-C).

PURPOSE: To evaluate the addition of cetuximab to neoadjuvant chemotherapy before chemoradiotherapy in high-risk rectal cancer. PATIENTS AND METHODS: Patients with operable magnetic resonance imaging-defined high-risk rectal cancer received four cycles of capecitabine/oxaliplatin (CAPOX) followed by capecitabine chemoradiotherapy, surgery, and adjuvant CAPOX (four cycles) or the same regimen plus weekly cetuximab (CAPOX+C). The primary end point was complete response (CR; pathologic CR or, in patients not undergoing surgery, radiologic CR) in patients with KRAS/BRAF wild-type tumors. Secondary end points were radiologic response (RR), progression-free survival (PFS), overall survival (OS), and safety in the wild-type and overall populations and a molecular biomarker analysis. RESULTS: One hundred sixty-five eligible patients were randomly assigned. Ninety (60%) of 149 assessable tumors were KRAS or BRAF wild type (CAPOX, n = 44; CAPOX+C, n = 46), and in these patients, the addition of cetuximab did not improve the primary end point of CR (9% v 11%, respectively; P = 1.0; odds ratio, 1.22) or PFS (hazard ratio [HR], 0.65; P = .363). Cetuximab significantly improved RR (CAPOX v CAPOX+C: after chemotherapy, 51% v 71%, respectively; P = .038; after chemoradiation, 75% v 93%, respectively; P = .028) and OS (HR, 0.27; P = .034). Skin toxicity and diarrhea were more frequent in the CAPOX+C arm. CONCLUSION: Cetuximab led to a significant increase in RR and OS in patients with KRAS/BRAF wild-type rectal cancer, but the primary end point of improved CR was not met.

A dicionarização de termos em língua brasileira de sinais (Libras) para o ensino de biologia: uma atitude empreendedora

Acompanha: Glossário de termos biológicos em língua brasileira de sinais (GBLI)

Modelagem eletroquímica e do distúrbio ácido-básico em atletas de karatê participantes do campeonato mundial WKO 2014

The objective of this study was to analyze the electrochemical and acid-base disorders in high performance athletes during the World Karate Championship hosted by the WKO (World Karate Organization) in 2014. In this study 19 male athletes were analyzed (age 34 ± 8), black belts and with over 5 years of experience in the sport. Capillary blood samples from the digital pulp of the finger were collected in three stages: rest, 5 minutes after and 10 minutes after fighting (kumite). The sample was analyzed using blood gas analyzer GEM Premier 3000, using the parameters pH, Na+, K+, Ca2+, lactate e HCO3−. The values related to acid-base disturbance presented statistical differences (p <0.05) in most of the collected moments. The lactate levels found were 2.77 ± 0.97mmol / L in rest, 6.57 ± 2.1 for 5 minutes after and 4.06 ± 1.55 for 10 minutes after combat. The samples collected for the electrolytic markers showed no statistical differences in their values (p <0.05). Through the data collected, we conjecture that the sport can be characterized as a high-intensity exercise and with a predominance of the glycolytic system. The analysis of acid-base disturbance is an efficient method to assist in the control of training loads.

Niveles de actividad física de niños y adolescentes durante las clases de educación física en tres colegios oficiales de Bogotá

La clase de educación física es un espacio en el cual los niños y adolescentes pueden incrementar los niveles de actividad física y alcanzar las recomendaciones emitidas por la Organización Mundial de la Salud (OMS), sin embargo, existe poca evidencia científica a nivel nacional sobre las actividades físicas que realizan los estudiantes dentro del ámbito escolar, específicamente dentro de las clases de educación física y sus relaciones con el contexto; es por esto que el objetivo de este estudio fue evaluar los niveles de actividad física de niños y adolescentes durante las clases de educación física en tres colegios oficiales de Bogotá, Colombia, por medio de la herramienta SOFIT. Estudio de diseño descriptivo y transversal realizado entre octubre de 2014 y mayo de 2015. Las observaciones se llevaron a cabo en tres colegios oficiales de la ciudad de Bogotá ubicados en las localidades de Tunjuelito y Ciudad Bolívar que aceptaron su participación en la investigación. Se obtuvo la aprobación para participar de 1361 estudiantes (682 niñas y 679 niños) de 5 a 17 años de los cuales 180 estudiantes (93 niños y 87 niñas) fueron seleccionados de manera aleatoria sistemática, siguiendo el protocolo SOFIT para observar su nivel de actividad física durante las clases de educación física. El 45,23% del tiempo de la clase de educación física los estudiantes mantuvieron un comportamiento sedentario; mientras que el 30.91% y el 23.86% del tiempo de la clase presentaron un nivel de actividad física moderada (AFM) y vigorosa (AFV) respectivamente. El nivel de actividad física moderada a vigorosa (AFMV), fue de 54,78% es decir, 35,27 minutos de la clase. Los docentes no promovieron la actividad física en un 56,47% del tiempo de la clase y se encontró que ningún docente promovió la actividad física fuera de la clase, es decir, alentando a sus estudiantes a que practicaran cualquier forma de actividad física en horas extraescolares. El contexto de la clase que más se desarrolló fue la condición física con un 35,66% del tiempo de la clase, seguido por los contextos de generalidades 24,83% y habilidades 23,84%. El contexto de la clase generalidades está asociada significativamente y de manera negativa (β=-0,32, p=0,006) con menor porcentaje de tiempo en AFM y AFV, las variables activas de SOFIT, lo que sugiere que las clases deben invertir menos tiempo en este contexto e incrementar el porcentaje de tiempo en los otros contextos como condición física y habilidades para aumentar la cantidad de minutos de AFMV en los estudiantes.

Modelo de gestión para la atención integral de pacientes con enfermedades huérfanas o raras en Colombia

Las enfermedades raras o huérfanas corresponden a aquellas con baja prevalencia en la población, y en varios países tienen una definición distinta de acuerdo con el número de pacientes que afectan en la población. La Organización Mundial de la Salud (OMS), las define como un trastorno que afecta de 650 a 1.000 personas por millón de habitantes, de las que se han identificado alrededor de 7.000. En Colombia su prevalencia es menor de 1 por cada 5.000 personas y comprenden: las enfermedades raras, las ultra-huérfanas y las olvidadas. Los pacientes con este tipo de enfermedades imponen retos a los sistemas sanitarios, pues si bien afectan a un bajo porcentaje de la población, su atención implica una alta carga económica por los costos que involucra su atención, la complejidad en su diagnóstico, tratamiento, seguimiento y rehabilitación. El abordaje de las enfermedades raras requiere un manejo interdisciplinar e intersectorial, lo que implica la organización de cada actor del sistema sanitario para su manejo a través de un modelo que abraque las dinámicas posibles entre ellos y las competencias de cada uno. Por lo anterior, y teniendo en cuenta la necesidad de formular políticas sanitarias específicas para la gestión de estas enfermedades, el presente trabajo presenta una aproximación a la formulación de un modelo de gestión para la atención integral de pacientes con enfermedades raras en Colombia. Esta investigación describe los distintos elementos y características de los modelos de gestión clínica y de las enfermedades raras a través de una revisión de literatura, en la que se incluye la descripción de los distintos actores del Sistema de Salud Colombiano, relacionados con la atención integral de estos pacientes para la documentación de un modelo de gestión integral.

El daño y el nexo causal en la perdida de oportunidad

El presente escrito se ocupa de estudiar el nexo de causalidad como elemento estructural de la responsabilidad cuando éste es difuso. Para ello, se pretende abordar la pérdida de la oportunidad como una teoría especial de causalidad que tiene lugar cuando el nexo causal no resulta claro, lo cual contradice la tesis preponderante de la doctrina y la jurisprudencia tradicional según la cual, la pérdida de la oportunidad es un criterio autónomo del daño. En su contenido se realiza una explicación del por qué se entiende la pérdida de la oportunidad como una teoría especial de causalidad y no como un criterio autónomo de daño, haciendo énfasis en el elemento de certeza que caracteriza al daño. Posteriormente, se advierte del tratamiento que la jurisprudencia le ha dado a la pérdida de la oportunidad. A su turno, el presente documento, indica la naturaleza jurídica de la pérdida de la oportunidad, afirmando que es una inferencia lógica que realiza el juez y no un hecho que altere el estado de las cosas como si sucede con el daño. Finalmente, se aborda la prueba de la teoría de la pérdida de la oportunidad mediante un cálculo de probabilidades y se identifican los pasos para realizar una adecuada reparación integral.

The meaning of 'material prejudice'

As dictated by s 213 of the Body Corporate and Community Management Act 1997 (Qld), the seller of a proposed lot is required to provide the buyer with a disclosure statement before the contract is entered into. Where the seller subsequently becomes aware that information contained in the disclosure statement was inaccurate when the contract was entered into or the disclosure statement would not be accurate if now given as a disclosure statement, the seller must, within 14 days, give the buyer a further statement rectifying the inaccuracies in the disclosure statement. Provided the contract has not been settled, where a further statement varies the disclosure statement to such a degree that the buyer would be materially prejudiced if compelled to complete the contract, the buyer may cancel the contract by written notice given to the seller within 14 days, or a longer period as agreed between the parties, after the seller gives the buyer the further statement. The term ‘material prejudice’ was considered by Wilson J in Wilson v Mirvac Queensland Pty Ltd.

Identification of New Zealand bats in flight from analysis of echolocation calls by artificial neural networks.

Time-expanded and heterodyned echolocation calls of the New Zealand long-tailed Chalinolobus tuberculatus and lesser short-tailed bat Mystacina tuberculata were recorded and digitally analysed. Temporal and spectral parameters were measured from time-expanded calls and power spectra generated for both time-expanded and heterodyned calls. Artificial neural networks were trained to classify the calls of both species using temporal and spectral parameters and power spectra as input data. Networks were then tested using data not previously seen. Calls could be unambiguously identified using parameters and power spectra from time-expanded calls. A neural network, trained and tested using power spectra of calls from both species recorded using a heterodyne detector set to 40 kHz (the frequency with the most energy of the fundamental of C. tuberculatus call), could identify 99% and 84% of calls of C. tuberculatus and M. tuberculata, respectively. A second network, trained and tested using power spectra of calls from both species recorded using a heterodyne detector set to 27 kHz (the frequency with the most energy of the fundamental of M. tuberculata call), could identify 34% and 100% of calls of C. tuberculatus and M. tuberculata, respectively. This study represents the first use of neural networks for the identification of bats from their echolocation calls. It is also the first study to use power spectra of time-expanded and heterodyned calls for identification of chiropteran species. The ability of neural networks to identify bats from their echolocation calls is discussed, as is the ecology of both species in relation to the design of their echolocation calls.

Teaching scenario analysis – An action learning pedagogy

In this paper we provide an introduction to our teaching of scenario analysis. Scenario analysis offers an excellent instructional vehicle for investigating ‘wicked problems’; issues that are complex and ambiguous and require trans-disciplinary inquiry. We outline the pedagogical underpinning based on action learning and provide a critical approach from the intuitive logics school of scenario analysis. We use this in our programme in which student groups engage in semi-structured, but divergent and inclusive analysis of a selected focal issue. They then develop a set of scenario storylines that outline the limits of possibility and plausibility for a selected time-horizon year. The scenarios are portrayed not as narratives, but as vehicles for exploration of the causes and outcomes of the interplay between forces in the contextual environment that drive the unfolding future in the context of the focal issue. In this way, we provide internally-generated challenges to both individual pre-conceptions and group-level thinking.

Electron Mean Energy, Secondary Ionization Coefficients And (E/P)Crit In Binary-Mixtures Of Sf6-N2 And Ccl2f2-N2

Measurements of the ratio of diffusion coefficient to mobility (D/ mu ) of electrons in SF6-N2 and CCl2F2-N2 mixtures over the range 80according to the following relationship: (E/p)c.mix=(E/p)c.N(2)+((E/p)c.A-(E/p)c.N(2)) (1-exp(- beta F/100-F)) and epsilon c.mix= epsilon c.N(2)+( epsilon c.A- epsilon c.N(2)) (1-exp(- beta F/100-F)) where A refers to the attaching gas, either SF6 or CCl2F2 and beta is a constant, equal to 2.43 for SF6 mixtures and 5.12 for CCl2F2 mixtures. In the present study, it has been possible to show that beta is indeed to a factor of synergism. Estimated gamma values (secondary ionisation coefficients) did not show any significant variation with F for F<50.

A microprocessor-controlled programmable pulse generator

The hardware and the software details of a user-friendly, simple, flexible and inexpensive pulse programmer using programmable counters interfaced to a microprocessor are described. The control of the various parameters that are required for NMR applications is implemented using the microprocessor. The basic hardware is extendable to other applications which require programmable pulse trains.