Perspectives in Vascular Surgery and Endovascular Therapy 

About: Perspectives in Vascular Surgery and Endovascular Therapy is an academic journal. The journal publishes majorly in the area(s): Emergency medical services & MEDLINE. It has an ISSN identifier of 1521-5768. Over the lifetime, 1736 publications have been published receiving 12037 citations.

When disaster strikes...the critical incident stress debriefing process.

Abstract: Major disasters over the past five years have brought attention to the fact that rescue workers themselves can become psychological casualties from the overwhelming carnage and suffeng they witness. The Critical Incident Stress Debriefing is a simple, but effective tool to help the emergency worker cope with what he has seen, and continue a productive career with minimal long-term effects

Greenhouse gas emissions.

Abstract: OVERVIEW The energy used in commercial buildings accounts for roughly one quarter of worldwide emissions of the greenhouse gases (GHG) linked to global climate change, making buildings an important part of your GHG inventory. In order to help you assess the emissions footprint associated with your energy consumption, Portfolio Manager incorporates a number of metrics to quantify these emissions and provide you with an understanding of how they are generated.   Total Emissions. Total Emissions is the primary metric, quantifying the majority of GHG associated with commercial buildings. It can be broken down into component metrics, also available in Portfolio Manager:   Direct Emissions. Emissions from fuel that is directly burned at your building, for example natural gas that may be combusted to heat your property. Indirect Emissions. Emissions associated with energy purchased from a utility, for example emissions associated with the generation of electricity or district steam. Biomass Emissions. Biomass emissions are an additional element in your inventory. These are emissions from biogenic fuels that are burned onsite, such as wood. Though combustion occurs on site, the emissions from burning biomass are accounted for separately from direct fossil fuel emissions because they may or may not reduce carbon emissions, depending on the type and source of the biomass resources. Emissions are calculated by multiplying your site energy values by emissions factors. These factors incorporate the emissions of carbon dioxide, methane, and nitrous oxide, to provide a single carbon dioxide equivalent number. Portfolio Manager uses custom factors for the U.S. and Canada, which are further regionalized to account for differences within each country. For properties in other countries, the U.S. factors are applied. Green power (electricity generated from environmentally preferable renewable resources, such as solar, wind, geothermal, low-impact biomass, and low-impact hydro resources) can have an important effect on your emissions inventory. Green power may be obtained from either onsite sources or offsite sources. We include a variety of metrics to help you understand the emissions benefit.   Offsite Green Power. When you purchase offsite green power, you are making a purchase of electricity from the grid bundled with environmental benefits defined by Renewable Energy Certificates (RECs). We show the emissions associated with a conventional grid purchase, the avoided emissions quantified in the REC, and the resulting net emissions benefit associated with the green power. Onsite Green Power. When you have an onsite renewable system, the implications …

Guidelines for field triage of injured patients. Recommendations of the National Expert Panel on field triage

Abstract: In the United States, injury is the leading cause of death for persons aged 1--44 years, and the approximately 800,000 emergency medical services (EMS) providers have a substantial impact on the care of injured persons and on public health. At an injury scene, EMS providers determine the severity of injury, initiate medical management, and identify the most appropriate facility to which to transport the patient through a process called "field triage." Although basic emergency services generally are consistent across hospital emergency departments (EDs), certain hospitals have additional expertise, resources, and equipment for treating severely injured patients. Such facilities, called "trauma centers," are classified from Level I (centers providing the highest level of trauma care) to Level IV (centers providing initial trauma care and transfer to a higher level of trauma care if necessary) depending on the scope of resources and services available. The risk for death of a severely injured person is 25% lower if the patient receives care at a Level I trauma center. However, not all patients require the services of a Level I trauma center; patients who are injured less severely might be served better by being transported to a closer ED capable of managing milder injuries. Transferring all injured patients to Level I trauma centers might overburden the centers, have a negative impact on patient outcomes, and decrease cost effectiveness. In 1986, the American College of Surgeons developed the Field Triage Decision Scheme (Decision Scheme), which serves as the basis for triage protocols for state and local EMS systems across the United States. The Decision Scheme is an algorithm that guides EMS providers through four decision steps (physiologic, anatomic, mechanism of injury, and special considerations) to determine the most appropriate destination facility within the local trauma care system. Since its initial publication in 1986, the Decision Scheme has been revised four times. In 2005, with support from the National Highway Traffic Safety Administration, CDC began facilitating revision of the Decision Scheme by hosting a series of meetings of the National Expert Panel on Field Triage, which includes injury-care providers, public health professionals, automotive industry representatives, and officials from federal agencies. The Panel reviewed relevant literature, presented its findings, and reached consensus on necessary revisions. The revised Decision Scheme was published in 2006. This report describes the process and rationale used by the Expert Panel to revise the Decision Scheme.

Transforming Growth Factor-β and Wound Healing:

Abstract: Acute and chronic wounds are a source of significant morbidity for patients, and they demand a growing portion of health-care time and finances to be devoted to their care. Transforming growth factor-β (TGF-β) has surfaced from abundant research as a key signal in orchestrating wound repair. In beginning this review, we discuss the inflammatory, proliferative, and maturational phases of wound healing. We then focus on TGF-β by first discussing the pathway from its production to the target cell where Smad proteins execute an intracellular signaling cascade. To review TGF-β's role in wound healing, we discuss the actions of it individually on keratinocytes, fibroblasts, endothelial cells, and monocytes, which are the major cell types involved in wound repair. From illustrating these cellular actions of TGF-β, we summarize its multipotent role in the process of wound repair. As a clinical correlation, we also review research dedicated to the involvement of TGF-β in venous stasis ulcers.