Search

The circulatory system alters its ability to respond to changes in blood pressure in the presence of converting enzyme inhibitors. Treatment with CEI changes blood pressure without disrupting heart rate, and this is facilitated by the lumbar sympathetic nerves. These nerves detect changes in mean arterial pressure in the presence of CEI so that they exert less effort in controlling arterial pressure while maintaining lower pressure in the arteries.

"Weather whiplash" is a colloquial phrase for describing an extreme event that includes shifts between two opposing weather conditions. Prior media coverage and research on these types of extremes have largely ignored winter weather events. However, rapid swings in winter weather can result in crossing from frozen to unfrozen conditions, or vice versa; thus, the potential impact of these types of events on coupled human and natural systems may be large. Given rapidly changing winter conditions in seasonally snow‐covered regions, there is a pressing need for a deeper understanding of such events and the extent of their impacts to minimize their risks. Here we introduce the concept of winter weather whiplash, defined as a class of extreme event in which a collision of unexpected conditions produces a forceful, rapid, back‐and‐forth change in winter weather that induces an outsized impact on coupled human and natural systems. Using a series of case studies, we demonstrate that the effects of winter weather whiplash events depend on the natural and human context in which they occur, and discuss how these events may result in the restructuring of social and ecological systems. We use the long‐term hydrometeorological record at the Hubbard Brook Experimental Forest in New Hampshire, USA to demonstrate quantitative methods for delineating winter weather whiplash events and their biophysical impacts. Ultimately, we argue that robust conceptual and quantitative frameworks for understanding winter weather whiplash events will contribute to the ways in which we mitigate and adapt to winter climate change in vulnerable regions. Plain Language Summary: Weather whiplash is a term used by researchers and the media to describe wild and rapid shifts in weather conditions. Here we investigate "winter weather whiplash" events, which are characterized by weather conditions swinging from frozen to unfrozen (or vice versa). These events have important consequences for ecosystems and communities, especially when they occur at unusual times of the year. Impacts of these events include tree damage, flooding, electrical outages, and crop damage. We use a series of case studies to explore the impacts of these events and analyze a long‐term data set to demonstrate how they might be detected from weather data. Understanding winter weather whiplash events will help decision makers and planners adapt and mitigate these events in the future. Key Points: Winter weather whiplash is defined as a rapid change in weather with temperature fluctuations above and below freezingAlthough rare, these events may have outsized impacts on coupled human and natural systemsIdentifying the occurrences of these events is critical in light of rapidly changing winter conditions [ABSTRACT FROM AUTHOR]

Geopolitics, a combination of geography and politics by default resembles the power politics of large states. As small states have little resources to pursue power-based foreign policy, one can wonder if the geopolitics of small states matter. This paper argues that small states use geopolitical tools to locate themselves on the winners' side. The current paper takes a closer look into the post-Cold War foreign policies of Estonia and Finland that originate from opposite principles. Estonia's principle of "never alone again", locates itself in the West. This differs from its neighbour Finland's principle "always alone", which locates itself as a strategic regional actor. To highlight the same but somewhat different reasoning in their foreign policies, the annexation of Crimea and the war in Ukraine are studied in this article by applying critical geopolitics as a methodological tool.

Intimate partner violence (IPV) is a major source of morbidity and mortality nationally. Trauma Centers can be very helpful for victims of IPV but there may be variability in IPV resource provision. A survey was mailed to each of the 65 Trauma Centers in Illinois. Stata and EZ-Text statistical software were used for analysis. Eighty-three percent of trauma centers returned the survey. Ninety percent of respondents had an IPV screening policy. All but one Center reported having IPV services available, including social work (93%) and 24 hour/day IPV teams (7%). Most Centers felt their IPV services were adequate (69%), but 22% felt services were inadequate, particularly resource availability. Trauma Centers in the state of Illinois are generally succeeding at screening for IPV. However, there is lack of uniformity with respect to screening and services, suggesting that there is room for improvement. [ABSTRACT FROM AUTHOR]

ISSUES AND PURPOSE. Although blunt trauma injury is a common cause for adolescent pain, little is known about the experience of pain as perceived by adolescents. DESIGN AND METHOD. Semistructured interviews were conducted with 13 adolescents following blunt trauma injury. Two age-appropriate valid measures (i.e., Adolescent Pediatric Pain Tool and Temporal Dot Matrix) were incorporated into the interviews to elaborate their pain experiences. Grounded theory method was used to analyze data and build substantive theory. RESULTS. Adolescents' behavioral and cognitive actions (i.e., 'internal control') to manage and endure pain were influenced by their pain perceptions, physical losses, and clinicians' actions. PRACTICE IMPLICATIONS. Nurses, family members, and peers have a crucial role in alleviating adolescents' distress and pain. [ABSTRACT FROM AUTHOR]

This article explores the experience of domestic violence and utilization of domestic violence resources among immigrant women who were Russian speaking. Participants, many of whom came to the United States as so-called mail-order brides, reported diverse forms of abuse, including isolation and financial restrictions, and were reluctant to get outside help because of embarrassment about their circumstances. Survivors stressed the importance of language- and culture-appropriate outreach and services and urged that women receive information about domestic violence services and laws on immigration. Assistance with housing, child care, and job searches is integral to safe transitions out of abusive relationships. [ABSTRACT FROM AUTHOR]

Pyogenic granulomas are common benign skin growths often present at sites of trauma. They can be difficult to treat in austere environments. A case report of a pyogenic granuloma in an austere environment has not previously been published. We submit this work to describe a case of a pyogenic granuloma arising from a properly treated laceration in an austere environment and to review current treatment options. Multiple treatment modalities are available to providers with limited resources to include topical Imiquimod, ethanol injection, silver nitrate application, and oral steroids. [ABSTRACT FROM AUTHOR]

It is estimated that more than 5 million stray dogs and cats enter animal shelters in the USA each year, but less than half are ever reunited with their owners. Lost pets with identification microchips are up to 21 times more likely to be reunited than those without. Finders of lost pets are more likely to consult veterinarians than shelters for assistance, and pet owners look first to veterinarians for advice regarding pet health, protection, and welfare. An online survey of 1086 veterinary clinics in the South-Eastern USA was conducted to evaluate how veterinary clinics functioned as a part of the pet identification network. Scanning and microchip implants were offered by 91% of surveyed clinics and 41% used 'global' scanners capable of detecting all currently used microchip brands. Clinics more frequently relied on pet owners to register contact information rather than providing this service for clients (52% vs. 43%, respectively). Even though lost dogs are more likely to be reunited with owners than lost cats, microchips and collars were more likely to be recommended for all dogs (85% and 93%, respectively) than for all cats (67% and 61%, respectively). Only half of clinics that recommended identification collars made them available to their clients. Veterinarians can protect animals, pet owners and the human-animal bond by integrating pet identification into preventive health care. [ABSTRACT FROM AUTHOR]

Introduction: There has been a substantial increase in the number of trauma centers (TCs) opened in the US over the past decade which coincided with population increases and policy changes. Our hypotheses were that new TC locations would likely be related to the socioeconomic profile of the surrounding locale-likely favoring higher-income areas-and that hospital ownership status may play a role in the distribution of new centers. Our aim was to use geographic information systems (GIS) analysis to evaluate the growth of an established regional TC and to delineate factors associated with the site chosen for new centers., Methods: ARC-GIS mapping software was utilized to generate a map of all TCs within two Florida metropolitan areas-Jacksonville and Miami. Hospital ownership was classified as for-profit (FP) or government, and opening dates were obtained from publicly available data. US census data (2020) was utilized to add sociodemographic data (race, income, insurance status) by zip code., Results: The majority of newer TCs opened in Duval/Clay and Dade/Broward counties were FP. GIS mapping demonstrated that 100% of new TCs demonstrated higher mean charges compared to established TC and were located in higher-income neighborhoods where residents were more likely to have health insurance with fewer African-American residents., Conclusions: Most TCs added to two of the largest metropolitan areas within Florida over the past decade were FP. These TCs demonstrated higher mean charges and tended to be located in areas of higher-income neighborhoods with better insured residents and fewer African-Americans. Such data suggest that more oversight is potentially needed to regulate and organize trauma system development to address trauma need rather than financial incentive alone., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: This manuscript provides a history of efforts by the American Public Health Association (APHA) Maternal and Child Health Section (MCH Section) Gun Violence Prevention Workgroup (GVP Workgroup) to promote gun violence prevention (GVP) as a key public health priority both within the MCH Section and APHA, and nationally., Description: The MCH Section established a gun violence prevention workgroup in response to the murders of twenty first-grade children and six adults at Sandy Hook Elementary School. This article presents an overview of the accomplishments and challenges of the MCH Section GVP Workgroup in a context of ever-increasing gun violence. As of 2020, firearms became the leading cause of death for U.S. children and teens., Assessment: Over the past decade, a small group of volunteers helped maintain GVP as one of the top priorities of both the MCH Section and APHA. Endorsement by the MCH Section and APHA leadership facilitated MCH Section GVP Workgroup efforts including organizing a national conference, developing scientific sessions for APHA annual meetings, establishing coalitions, and providing ongoing education and outreach to APHA members., Conclusion: The MCH Section GVP Workgroup helped to both elevate and maintain focus on GVP as a top priority of the MCH Section and APHA, indirectly impacting national efforts to promote a public health approach to GVP. The ongoing epidemic of firearm violence highlights the importance of continuing and strengthening this work. Individuals at other national, state or local organizations might look to the efforts and accomplishment of the MCH Section GVP Workgroup in pursuing critical issues within their own organizations., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Little research has focused on assessing the mortality for fall height based on field-relevant categories like falls from greater than standing (FFGS), falls from standing (FFS), and falls from less than standing., Methods: This retrospective observational study included patients evaluated for a fall incident at an urban Level I Trauma Center or included in Medical Examiner's log from January 1, 2015, to June 31, 2017. Descriptive statistics characterized the sample based on demographic variables such as age, race, sex, and insurance type, as well as injury characteristics like relative fall height, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), traumatic brain injury, intensive care unit length of stay, and mortality. Bivariate analysis included Chi-square tests for categorical variables and Student t-tests for continuous variables. Subsequent multiple logistic regression modeled significant variables from bivariate analyses, including age, race, insurance status, fall height, ISS, and GCS., Results: When adjusting for sex, age, race, insurance, ISS, and GCS, adults ≥65 who FFS had 1.93 times the odds of mortality than those who FFGS. However, those <65 who FFGS had 3.12 times the odds of mortality than those who FFS. Additionally, commercial insurance was not protective across age groups., Conclusions: The mortality for FFS may be higher than FFGS under certain circumstances, particularly among those ≥65 y. Therefore, prehospital collection should include accurate assessment of fall height and surface (i.e., water, concrete). Lastly, commercial insurance was likely a proxy for industrial falls, accounting for the surprising lack of protection against mortality., (Copyright © 2024 Elsevier Inc. All rights reserved.)