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Management of pit viper snakebites incorporating the use of antivenom is defined in this chapter. This chapter on adult snakebite treatment chapter reviews the basic management parameters needed in the care of North American pit viper envenomations. The chapter provides a brief overview of the classification of severity grading, indications for antivenom administration, assessment parameters, and disposition criteria. The chapter has an easy-to-follow diagram to assist in treatment evaluation of this patient population.
Chapter 4 examines social protocols in public discourse, representing the realm of ‘overly’ ordinary language use. The term ‘public discourse’ means both monologues and dialogues that take place in public, often through mediatised events or written (online) pieces which are available for, or even addressed to, members of the public. ‘Social protocols’ describe forms of language use associated with ‘politeness’ in public discourse specifically, where ‘politeness’ in the interpersonal sense is hardly needed, i.e., such forms at first sight may seem to be entirely ‘superfluous’ if not ‘redundant’. Because if this, while social protocols and mediatised public aggression (studied in Chapter 3) may appear to have little in common at first sight, interestingly both of them have an ‘unreasonable’ element. This sense of unreasonableness however dissolves once one looks at such forms of language use through the ritual perspective. As a case study, Chapter 4 examines the ritual conventions of social protocols in a corpus of Chinese public announcements made in the wake of a major social crisis.
Planned actions, as prescribed in protocols and trained in exercises, help frontline responders take action under enormous pressure. Yet, these same actions are often hard, if not impossible, to implement during crises, either because the specific situation was not anticipated and there are no plans in place or because prepared plans do not produce the desired results. As a consequence, frontline responders will need to improvise and adapt their activities to crisis situations. Yet, improvisation under extreme stress is very difficult and may be inefficient or even dangerous to responders. The resulting dilemma for responders is how to choose the right course of action. This requires a view of both action patterns as complementary and even mutually conducive, as most crises will demand a combination of plans and improvisation. Reflective acting helps frontline responders to find the right balance and define adequate response activities.
Intimate partner violence against women (IPVAW) is a public health problem that affects women worldwide. Consequently, victims frequently go to healthcare centers, usually with a cover reason. To address this problem, national and autonomic protocols to respond to IPVAW in health systems have been developed in Spain. In this regard, the role of primary care physicians (PCPs) will be essential for addressing IPVAW, but they could encounter obstacles in doing so. The purpose of this study was to explore how IPVAW is addressed in healthcare centers in Spain. This study synthesized the information available in the protocols to address IPVAW among health care workers in Spain and analyzed it according to World Health Organization (WHO) guidelines. Additionally, PCPs’ perspectives on these protocols and the nature of IPVAW attention from healthcare centers were explored through a focus group. The findings displayed that, although the protocols mostly conform to WHO guidelines, they are insufficient to address IPVAW. Generally, PCPs were unaware of the existence of the protocols and referred to the lack of training in IPVAW and protocol use as one of the main obstacles to intervening, along with a lack of time and feelings as well as cultural, educational, and political factors. The adoption of measures to ensure that PCPs apply these protocols correctly and to approach PCPs’ obstacles for addressing IPVAW in consultations will be crucial for the care of victims.
To ascertain the rational credences for the epistemic agents in the famous cases of self-locating belief, one should model the processes by which those agents acquire their evidence. This approach, taken by Darren Bradley (Phil. Review 121, 149–177) and Joseph Halpern (Ergo 2, 195–206), is immensely reasonable. Nevertheless, the work of those authors makes it seem as if this approach must lead to such conclusions as the Doomsday argument being correct, and that Sleeping Beauty should be a halfer. I argue that this is due to an implicit existential bias: it is assumed that the first step in those processes is the determination that the agent in question must necessarily exist. It is much more reasonable to model that determination as contingent and a result of other, earlier, steps in the process. This paper offers such alternative models. They imply an endorsement of what has mockingly been called “presumptuous” reasoning, and a massive shift of credences in favor of (1) the existence of a multiverse and (2) the Everettian interpretation of quantum mechanics.
This book will enable practitioners to understand the many complex intricacies of immunohistochemistry (IHC) and make best use of this powerful analytical tool. Providing a thorough grounding in the fundamentals of immunohistochemistry, the book includes several chapters on robotics and automation technology, giving key information on the design of machines and tips to maximise workflow efficiencies. The relationship between IHC and molecular pathology is explained clearly, demonstrating the increasing impact on personalized medicine and targeted therapies for cancer patients. The staining protocol is deconstructed, allowing the reader to adapt it for a variety of diagnostic and research applications. Written by experts at the forefront of hospital immunohistochemistry, there is a strong emphasis on practical guidance on a range of techniques as well as troubleshooting of common problems driven by the authors' experiences. Extensively illustrated with high-quality colour images, this is an invaluable resource to all pathology practitioners utilising the technique.
The late Russian empire was notorious in the West for policies discriminating against its large Jewish population and for outbursts of anti-Jewish mob violence known as pogroms. As the country descended into revolution and civil war, antisemitism served the ideological purposes of both the Russo-centric counterrevolution and the anti-imperial nationalist mobilization, with fatal consequences for the Jews.
A 55-year-old woman presents to the office to discuss a scheduled total abdominal hysterectomy and bilateral salpingectomy that is planned due to uterine fibroids and pressure symptoms. She has no contributory past surgical history and has no known drug allergies. The patient has severe gastroesophageal reflux disease (GERD), and was told by her primary care provider to never take ibuprofen. During preoperative counseling, she enquires about your institution’s protocols for enhanced recovery after surgery.
Since the establishment of the first radiocarbon accelerator mass spectrometry facility in Latin America in 2009, the Radiocarbon Laboratory team of Universidade Federal Fluminense (LAC-UFF) has worked to improve sample preparation protocols and increase the range of environmental matrices to be analyzed. We now present the preliminary results for DIC sample preparation protocols. The first validation tests include background evaluation with pMC value (0.35 ± 0.04) using bicarbonate dissolved in water. We also analyzed surface seawater resulting in pMC value (101.38 ± 0.38) and a groundwater previously dated from LEMA AMS-Laboratory with pMC value (12.30 ± 0.15).
We have seen in Chapter 9 that we have many avenues to improve medication safety in anesthesia and the perioperative period, with considerable evidence and expert consensus to support them. However, human nature, just as it leads to errors, also often drives resistance to implementing safety interventions. Complicating our efforts to improve safety are safety paradoxes that, although would seem to improve safety, actually may work against safety. Achieving improved patient safety requires a deep understanding of not just how things go wrong when error-prone human beings work within complex systems but also why changes that would have a high probability of reducing the risk of errors are so often resisted. Needed changes can be resisted by individual physicians and by entire leadership of a large healthcare system. We return to the concept of violations, and emphasize that failure to hold violators accountable will effectively undermine safety efforts. Finally, an effort to understand why we do not change is absolutely imperative, as our continued refusal to change to safer methods continues to imperil our patients.
In recent years, the Schengen Area—and the suppression within its territory of border controls—has become a strong focus of attention. This article focuses on another region of Europe where such controls have been suppressed: the Common Travel Area (‘CTA’). Historically, both Ireland and the United Kingdom have rejected membership of the Schengen system—albeit securing certain ‘opt-in’ rights—and instead maintained the CTA between their respective jurisdictions. The CTA has, however, garnered relatively little public attention until recently, when concerns as to the implications of Brexit for the maintenance of an open border between Ireland and Northern Ireland have gained ground, and threatened to be a deal breaker in the negotiations under Article 50 TEU on UK exit from the EU (‘Brexit’). This article examines the background to the CTA, exploring its surprisingly fluid legal framework; its development in the legal systems of Ireland and the United Kingdom; and subsequently, how it was exempted from what is now EU law as the Schengen arrangements were integrated into the Union. The recent introduction of the British-Irish Visa Scheme, which formalises some visa rules regarding citizens of third states, and which tends in the direction of consolidating CTA arrangements, is also examined. The article further explores the challenges that confront the CTA in coping with the outcome of the June 2016 Brexit referendum, which should result in the UK leaving the European Union in March 2019, and the implications of Brexit for the CTA. Finally, it seeks to identify some key characteristics of the CTA in light of experience to date.
Systematic reviews answer specific review questions by following structured steps and employing specific methods to reduce the risk of bias and to maximize transparency in the process of the review, and systematic review methodology differs from traditional narrative reviews in many ways. As a journal devoted to reviews, it is appropriate that Animal Health Research Reviews (AHRR) includes this approach to reviews of the literature. The aim of this special issue of AHRR was to illustrate the scope of articles that can be considered for submission to the systematic review section of this journal for prospective authors and readers.