text:
my Nutrition
my Fitness
Other Goals
my SparkPoints
Web Search
Articles & Videos Home
Health & Wellness
Health A-Z
Cold & Flu
GERD (Heartburn)
Healthy Heart
High Blood Pressure
High Cholesterol
Irritable Bowel Syndrome (IBS)
Pain Management
Seasonal Allergies
Weight Loss
Healthy Family
Pregnancy & Postpartum
Instant Inspiration
Lifestyle Centers
Beauty & Style
Brides To-Be
Family Wellness
Healthy Home
Pet Health
Senior Health
The SparkPeople Blog
Community Home
Message Boards
Challenge Central
Secrets of Success
Member Blogs
Friend Feed
Advertisement --
Learn more
about ads on this site.
April No Excuses challenge: FAIL
Thursday, April 04, 2013
This is an easy post to write. I was supposed to do day 3 of the challenges; I didn't.
OK, yes, there's more to it, and no, there are NO excuses. I woke up with a couple of hours to spare before I had to be at my folks' house for the rest of the day. I told myself I should do the workouts because I probably wouldn't have time later. I'm very sore from the past 2 days workouts, so I "let" myself sit around for a little bit...which turned into me getting up just in time to leave the house a few minutes late to get my folks'.
When I got to their house and found myself snapping at Dad, I realized that the depression I've been successfully fighting off for the last few days was picking up steam. I thought about it and realized I'm still hung up on my lay off. I know the "official" reason I was given for my lay off. I also know, and my former employer knows, that the reason was crap. I know there's more to it, and I think I have a sense of what it's all about, and it just leaves me depressed.
I worked for the agency for 16 months. I worked pretty exclusively for and with one woman for 14 of those months, and we developed what I thought was a good, respectful working relationship. While she was younger than me and a first time, inexperienced manager, she knew her stuff regarding social work, policy development, and quality assurance and I felt that I was learning from her. As with any boss, we had our ups and downs and, according to her, we grew a lot in working together and were developing a great rapport.
Beginning of January, she went on maternity leave at the same time I left for Florida for 2 weeks to run Ragnar (fattofinish.com). Minus the 1 week I was in New Orleans for a training, I was in the office 6 weeks with my boss on leave; during this time, I reported to her boss, the COO of the agency, and someone with whom I'd really never interacted.
I was laid off on a Friday. The previous Thursday and Friday, I'd been in Philadelphia, speaking at a conference at the invitation of both a national and state agency, representing my agency. Monday of the week I was laid off, I had a meeting with the COO and CEO and was told that my position was part of the future of the agency, that the agency was moving in a direction where my position would be integral. Five days later, I was told my position was being eliminated due to budget cuts.
Yes, there is an extenuating circumstance that contributes to this story. I had attended a training at another company's office (we�ll call them XYZ) mid-February. During that Monday meeting, I was told that the president of XYZ (a primary consultant and major contributor to and sponsor of agency fundraising, BTW) had said that I acted unprofessionally in the training. Anyone who knows me knows how absolutely insane that allegation is. I've been accused of being TOO professional (aka, a little uptight) before, yet suddenly I was swinging the other way and disrupting meetings?
There were 6 people in the training, including the trainer, including me, and including 2 of my coworkers. I begged my CEO and COO to talk to these people, to get me details, to help me figure out what was going on. Later that week, I had 2 more meetings with the COO, both at my request. Both times, I asked for more details and only had "unprofessional" reiterated; I was given no details or examples of what I allegedly did. The last meeting with the COO was on Wednesday when I was told the president of XYZ had written a memo, but my COO couldn't provide me a copy yet. I expressed my interest in continuing to work for the agency, to grow my position, to be the person they were looking for to fill the role. She said we'd talk more at our next meeting; that turned out to be my lay off meeting.
I'm incredibly disappointed that the agency, and its leaders, aren't what and who I thought they were.
Most of all, I'm disappointed in my boss. The last time I heard from her was the night before I left for Philadelphia when she IMd me from home to wish me luck at the conference. I've e-mailed her twice asking for a written letter of reference and she hasn't acknowledged my e-mails.
I was told I was being let go because of budget, not performance issues; this point was stressed to me. I was told I'd get a positive recommendation; now I can't get a response to my e-mails. I have no idea about the allegations from XYZ; despite repeated requests to my former agency, I've not received a copy of the memo, or even a reply. I feel like I've been blacklisted.
Really, all I know for sure is that I was laid off for a truly bogus reason. And I may (will) never know the real reason. And I have to figure out how to be OK with that. Today, on my old agency's Facebook wall, I saw a post thanking XYZ for sponsoring the agency's main upcoming fundraiser. I think that might be the only answer I'll get. I feel like I was a victim of politics, or personalities. And yet, despite all that, I still feel like it's somehow my fault.
Share This Post With Others
Report Inappropriate Blog
Member Comments About This Blog Post
Report Inappropriate Comment
My SparkPage
That's a lot to bare. I'm sorry Allison how this all went down and yes, the thought of you acting in any way inappropriately is absurd.
I am sensitive and suffer from bouts of depression so it's easier said than done (and know how hard this is) but I hope you can find a way to "be OK with it." You can't really control their actions only your reaction and driving yourself insane about it just hurts you further.
You are wonderful, driven, strong. Stay your course. Don't say words like "fail" you didn't fail day 3 - you needed a "wallow day", pick up the extra work along the way and just do your best.
1153 days ago
Add Your Comment to the Blog Post
Log in to post a comment
Disclaimer: Weight loss results will vary from person to person. No individual result should be seen as a typical result of following the SparkPeople program.
Advertisement --
Learn more
about ads on this site.
Get An Email Alert Each Time
LYSSAYN Posts
See Today's Featured Member Blog Posts
More Blogs by LYSSAYN
April No Excuses challenge: Day 7
- 4/9/2013
April No Excuses challenge: Day 6
- 4/7/2013
April No Excuses challenge: Day 5
- 4/6/2013
April No Excuses challenge: Day 4
- 4/6/2013
View All ›
close ×


text:
CONCORD, N.H. (AP) — Former U.S. Sen. Warren B. Rudman, who co-authored a ground-breaking budget balancing law, has died at age 82.
Rudman's Washington, D.C., firm, the Albright Stonebridge Group, says he died Monday night.
The feisty New Hampshire Republican went to the Senate in 1981 with a reputation as a tough prosecutor. He was called upon by Senate leaders and presidents of both parties to tackle tough assignments.
He is perhaps best known for his co-sponsorship of the Gramm-Rudman-Hollings budget cutting law. He left the Senate in 1993, frustrated that the law never reached its potential because of Congress.
Before his election to the Senate, he served six years as New Hampshire's attorney general.

subset: commoncrawl


text:
The 200th anniversary last week of the end of the British slave trade, the ongoing controversy over George Washington's slave quarters at the President's House site at Sixth and Market Streets, and the proposed demolition of a house outside Princeton containing slave quarters ("N.J. slave quarters threatened," March 26), bring to mind how little we know (or have been taught) about slavery.
I attended last spring's "Slavery in New York" exhibit at the New York Historical Society, and one statistic bowled me over more than anything else in the show. In a comparison of tax records from 1703, 3 percent of Boston taxpayers were slave-holders, as were 6 percent of Philadelphia taxpayers, and 42 percent of New York City taxpayers. Forty-two percent! A higher percentage than even in the Deep South.
That means slaveholding wasn't just an upper-class, or even a middle-class, phenomenon. Enslaved Africans were so cheap and plentiful in New York City that even working-class people could, and did, choose to own them. It also speaks volumes about the price of manual labor, white or black.
Pennsylvania's was the first government in the Western Hemisphere to begin an abolition of slavery — something of which we can be justly proud. But the 1780 Gradual Abolition Law was so respectful of slaveholders' property rights that it freed no one at first. Importing additional enslaved Africans into the state was prohibited, and the future children of those already here were to be born free (although indentured to their mother's master until age 28). All enslaved Africans held in the state before the law went into effect remained enslaved for life.
It wasn't until 1847 that the Pennsylvania Assembly finally ended legal slavery and freed these people, the youngest being 67. Slavery didn't end in New Jersey and Delaware until 1865, the same time it ended in the South.
The Independence Hall Association has posted a primer on slavery at the President's House at http://www.ushistory.org/presidentshouse/slaves/numbers.htm. Slavery in the North is likely to become a major subject of study for the next generation. This primer may be a good place to start.
Edward Lawler Jr.
Independence Hall Association


text:
Electrical Engineer (15194BR) Sydney, Canada
Hatch Mott MacDonald (HMM) is an award-winning consulting engineering firm with major success in the fields of architectural services; highway and bridges; aviation; rail and transit; water and water resources; wastewater; environment; municipal engineering; ports and harbors; tunnels; and pipeline services. We have earned a reputation for technical excellence on some of the world's most prominent and challenging projects. With offices throughout North America, HMM provides a full range of services, from planning and design through construction management. We are seeking highly motivated individuals to join our dynamic team of professionals in locations throughout the US and Canada.
We are seeking an Electrical Engineer to join our team in Sydney, Nova Scotia.
Responsibilities include, but are not limited to: Ability to deliver projects with a minimum of supervision; Demonstrate a track record of electrical and electronic design and design team leadership as well as project management; Ensure that all work produced complies with company, national, industry and project quality requirements, understanding at least the principals of quality assurance and health and safety best practices; Ability to check and review own work and ability to check the work of others; Support the team for various projects ensuring timely and profitable delivery of works, quality of deliverables and budgetary control; Maintain good working relationship with other team members.
Qualifications/Skills required to be successful in this position: B.Eng. in electrical engineering; Registered as EIT or P.Eng. in the Province of Nova Scotia; Two (2) to five (5) years of experience in the field of electrical design engineering and simulation; Working knowledge of CAD (Autodesk/Bentley) with ability to produce CAD drawings; Be familiar with various analysis methods including hand calculations and computer modelling using electrical engineering analysis software; Good skills to assess the functioning of systems, search problems and identify solutions; Team player with strong work ethic; Fluency in English both written and spoken is essential; Ability to work with minimal supervision; Ability to work in order to meet the objectives of cost, quality and time; Demonstrate good time management skills and be able to adapt to change; Excellent communication, interpersonal and teamwork skills in complex and changing environments; On-site work experience in an industrial environment is an asset; Experience with programmable logic controls (PLC's) and human machine/graphical interface (HMI) software would be an asset.


text:
KAR : Analysis & Opinions
Don't Sell A Single Stock Before Checking These 5 SignsJune 19, 2013The S&P 500 is on fire. The index is on track for its ninth consecutive month of gains. And chances are any stock you've ...
Private Equity Kills Balance SheetsDecember 24, 2010We'll use the Z-Score to illustrate how private equity is hurting the financial footing of acquired companies.
Trading Center


text:
Lions at a glance
Head coach: Travis Williams (3rd season)
Assistant coach: Frank McDonough
Last season: 9-15 overall, 8-9 PSUAC
Probable starters: Patrick Killian (6-1, sr., G), Colin Nurse Jr. (6-3, jr., F), Paul Carey (6-4, sr., F), Omar Jiminez (6-2, sr., F), Nate Yost (5-10, fr., G)
Other key players: Michael Stewart (5-10, soph., G), Andrew Hines (5-10, soph, G), Romo Morrison (6-5, soph., C), Thomas Tinsley (6-2, soph., F), Chris Gamble (6-2, fr., F)
Outlook: Killian, and his 15.4 ppg from a year ago, returns to lead a Lions team with winning expectations. Four regulars from a year ago will start for Williams' guard-oriented squad. The lone newcomer to the starting lineup is freshman Nate Yost, a Blue Mountain graduate, who will run the point and distribute to scorers Killian, Nurse Jr. and Carey. The undersized squad may find trouble rebounding but will be an exciting, up-tempo team to watch.
To comment you must first create a profile and sign-in with a verified DISQUS account or social network ID. Sign up here.
Comments in violation of the rules will be denied, and repeat violators will be banned. Please help police the community by flagging offensive comments for our moderators to review. By posting a comment, you agree to our full terms and conditions. Click here to read terms and conditions.


text:
I know that these are terrible photos, but I really don't want to go back out through the rain to try again right now.
I have a Schwinn world tourist, with a tear on the bottom of the compression groove for the seat collar on the top of the seat tube. I tried putting some arrows in there to show where it is. the discoloration above it is just chipped paint.
The frame is to small for me, so I would like to get it a home with someone who would find it worthwhile to try to either live with it or fix it. So is this frame salvagable? Should I ebay it? throw it away?(actualy not going to happen).
any suggestions welcome


text:
A-Z Health Topics
Return to Index
Screening for Generalized Anxiety Disorder (GAD)
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
There are questionnaires, such as the GAD-7, that doctors use for screening and assessing the severity of GAD.
Generalized anxiety disorder. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated September 2008. Accessed October 30, 2008.
Spitzer RL, Kroenke K, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med . 2006;166:1092-1097.
Revision Information
- Reviewer: Michael Woods, MD
- Review Date: 05/2015
- Update Date: 05/20/2015


text:
- 5 years ago by Jennifer Wright
- No Comments »
- Share a Tip
I do realize this person no longer dates Blake Lively… More
I do realize this person no longer dates Blake Lively… More
The least annoying Will and Kate wedding ephemera: Legos. -Styleite
Selma Blair, Penn Badgley, Nikki Reed, Ginnifer Goodwin, and more are fronting are fronting H&M's Fashion Against Aids campaign. -Poshglam
The world's most uncomfortable undergarments. -The Frisky
Gisele has a girl only shoot in Numero Tokyo, in which she dons a littler Prada and a whole bunch of wigs. -Fashion Indie
This is fashion's most iconic advertisement. -Full Frontal Fashion
A rhino tattoo gets you a lifetime discount at Ecko. -Coco Perez More
Stanley Tucci, who has stolen hearts and scenes in movies like The Devil Wears Prada and Burlesque, is now getting his own talk show where he talks about wine. The show, Wine Talk, will hit public television – I assume this means PBS? – in April, but the first episode is up on YouTube. More
I love a man who wears a basic white t-shirt and jeans. Simple yet clean, refreshing and it's pretty much a classic casual look for any Men. A lot of celebrities sure have pulled this look effortlessly and made a … More
Here are the hunks from CW Hit Gossip Girl. Penn Badgley and Ed Westwick at the 2008 Teen Choice Awards Arrivals. While Penn Badgley opted for a tan brown casual dress shirt & black jeans, Ed Westwick on the other … More
Now if only Penn Badgley would uncross his arms then we'd see the whole printed necktie :). I'm surprised the Gossip Girl hunk is not wearing jeans with this dress shirt and tie casual wear ala Patrick Dempsey :). He … More
Here's Penn Badgley from Gossip Girl in his casual attire of white dress shirt, gray trouser and lace-up shoes. Effortless. It seems the Gossip Girl guys are giving their female counterparts a run for their money and 3 inches heels … More


text:
Who Killed Bambi
|Release Date: November 12, 2004
|Running Time: 126 mins.
|Genre: Drama, Foreign, Thriller
Sophie Quinton
Laurent Lucas
Catherine Jacob
Yasmine Belmadi
All Cast & Crew >>
Summary:Isabelle is a naïve student nurse working in the surgical unit of a high-tech, very spartan, hospital, surrounded by a dark forest. Isabelle finds solace in, Véronique, her cousin who works in the same unit and lives in the nurses' dormitory overlooking the hulking hospital. Plagued with an inner-ear problem which causes fainting spells and unsteadiness in her legs, the doe-eyed Isabelle comes to the attention of the cool Dr. Philipp who nicknames her with the unappreciated sobriquet "Bambi." Isabelle is increasingly puzzled by this dedicated surgeon who seems to haunt the hospital by day and night, and shows an unhealthy interest in her malaises--not to mention his female patients. As st... Full Summary >>


text:
The Authors: Professor Bruce Robinson MBBS MD FRACP FRCP DTM&H FCCP is a Professor of Medicine and a Consultant Respiratory Physician, Director of the National Centre for Asbestos Diseases and is also the Director of the International Skills and Training Institute in Health (ISTIH). Dr Mohammad Fahmi Alatas MD is a Fellow of Pulmonology and Respiratory Medicine at the University of Indonesia and currently a Visiting Research Fellow at the University of Western Australia. Dr Andrew Robertson MBBS MPH MHSM FAFPHM FRACMA is the Deputy Chief Health Officer and Director, Disaster Management, Regulation and Planning at the Western Australian Department of Health. Dr Henry Steer BM BS B Med Sci MRCP is a Specialist Registrar in Respiratory Medicine in the Severn Deanery, UK and is currently a Research Fellow at the University of Western Australia.
Natural disasters and the lung
Version of Record online: 30 MAR 2011
DOI: 10.1111/j.1440-1843.2011.01923.x
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology
Volume 16, Issue 3, pages 386–395, April 2011
Additional Information
How to Cite
ROBINSON, B., ALATAS, M. F., ROBERTSON, A. and STEER, H. (2011), Natural disasters and the lung. Respirology, 16: 386–395. doi: 10.1111/j.1440-1843.2011.01923.x
Publication History
- Issue online: 30 MAR 2011
- Version of Record online: 30 MAR 2011
- Accepted manuscript online: 18 JAN 2011 07:07AM EST
- Received 16 December 2010; invited to revise 17 December 2010; revised 20 December 2010; accepted 21 December 2010 (Associate Editor: Y. C. Gary Lee).
- Abstract
- Article
- References
- Cited By
- aspiration;
- disaster;
- infection;
- inhalation;
- pulmonary
- Top of page
As the world population expands, an increasing number of people are living in areas which may be threatened by natural disasters. Most of these major natural disasters occur in the Asian region. Pulmonary complications are common following natural disasters and can result from direct insults to the lung or may be indirect, secondary to overcrowding and the collapse in infrastructure and health-care systems which often occur in the aftermath of a disaster. Delivery of health care in disaster situations is challenging and anticipation of the types of clinical and public health problems faced in disaster situations is crucial when preparing disaster responses. In this article we review the pulmonary effects of natural disasters in the immediate setting and in the post-disaster aftermath and we discuss how this could inform planning for future disasters.
- Top of page
Barely a year passes without a major natural disaster occurring. Some recent examples of such damaging events include the 2004 Indian Ocean tsunami and the 2009 Sumatran and 2010 Haitian earthquakes (Fig. 1). Asia is particularly susceptible to the effects of natural disasters because of its geology, especially in relation to earthquakes, volcanoes and tsunamis, and its high population density. The victims of such disasters are not just those killed and injured but those displaced by the disaster and those whose access to health care is vastly compromised. All survivors of disasters are at increased risk of pulmonary disease. Such lung problems may occur as a direct result of the disaster itself, such as inhalation of tsunami water or volcanic dust, or may occur as a result of the post-disaster situation, for example, overcrowding leading to respiratory infections. This review discusses the range of these pulmonary problems with a view to informing and assisting those responding to disasters to better plan their responses. Although some major disasters are man-made, such as terrorist bombs, this review focuses only on natural disasters. The personal experience of the authors includes established leadership roles in training programmes for disaster preparedness and response plus service in Aceh and the Maldives following the 2004 Indian Ocean tsunami, Jogjakarta after the 2006 earthquake, Padang after the 2009 earthquake and Haiti after the 2010 earthquake, which cumulatively killed over half a million people and left many millions more displaced.
- Top of page
Many pulmonary complications that occur following natural disasters are a direct result of the disaster itself. The mechanism of insult to the lung as a consequence of a natural disaster will vary depending on the nature of events, but in broad terms can be considered under the following categories
- • Inhalation of respirable particles, smoke or other toxic gases
- • Aspiration of water and water borne pathogens
- • Direct trauma to the chest
- • Psychological effects causing respiratory symptoms
Smoke inhalation is common due to increased population exposure to wild fires.1 In addition, fire can be a major cause of morbidity and mortality in other natural disasters, accounting for almost 10% of deaths following the Hanshin-Awaji earthquake in 1995.2
Inhalational lung injury occurs in a round one-fifth of all burns victims; however, this number rises to around two-thirds if central facial burns are present.3 Lung injury accounts for the majority of fire-related deaths and the mortality in burns cases increases from 4% to around 30% if inhalation injury is present.4,5
Direct thermal injury to the upper airways is common but thermal injury to the lower airways is rare.6 As well as carbonaceous particulates (soot), wood smoke contains a diverse variety of respiratory irritants, including sulphur oxides, nitrogen oxides, phenols, formaldehyde and gaseous acids and alkalis,7 which cause mucosal inflammation and acute lung injury. Poorly water-soluble substances may cause delayed injury up to 48 h after exposure.3 In addition, absorption of systemic toxins such as carbon monoxide and hydrogen cyanide, generated through incomplete combustion, can result in impairment of oxygen delivery and cellular respiration.3,8
The manifestations of an acute smoke inhalational injury may not occur immediately, and can take several hours to develop.3 The CXR is an insensitive early indicator of smoke inhalation injury9 and serial X-rays may be required to detect the development of pulmonary oedema/ARDS. In intubated patients, direct inspection of the airways by bronchoscopy if available, allows visualization and assessment of the degree of mucosal injury.8
Early intubation should be considered for any patient where a significant inhalational injury is suspected and as such it is important that personnel with appropriate airway management skills are involved at an early stage.3,6 Nebulization of adrenaline and corticosteroids has been used to try and minimize airway oedema although there is no conclusive evidence of efficacy.3
Natural wildfires are associated with deteriorations in air quality and elevated levels of atmospheric particulates, carbon monoxide and carbon dioxide.10 Although some have reported little or no impact of bushfires on daily mortality,11,12 or on presentation to hospital,13 other studies have shown that increases in levels of respirable particulates (<10 µm in diameter—PM10) following bushfires have been associated with increased respiratory symptoms, respiratory-related emergency department attendances or hospital admissions, particularly for those with asthma and COPD.10,14–18 The 1997 haze disaster in Indonesia caused by forest fires led to over 500 haze-related deaths in a 3-month period, with around 300 000 episodes of asthma, 50 000 cases of bronchitis and 1.5 million respiratory infections reported during this time.10,18 Furthermore, increases in PM10 levels in Malaysian cities during this period were associated with an increased risk of cardiovascular and respiratory deaths, especially in the elderly.19
Volcanic emissions
Post-mortem studies on victims killed by the 1982 St Helens volcanic eruption demonstrated that over 80% died as a result of asphyxiation due to bronchial obstruction following ash inhalation.20,21 Three patients caught in the periphery of the pyroclastic flow were treated in hospital for severe thermal and inhalational injuries, with ARDS developing as a fatal complication in two.22
Toxic volcanic gases, including carbon dioxide, sulphur dioxide, acid aerosols and hydrogen sulphide, can be released during eruptions and during non eruptive periods and it estimated they account for up to 4% of volcano-related deaths.23 Although observational studies have reported increased respiratory morbidity as a result of exposure to volcanic sulphur dioxide and acid aerosols,23,24 the highly heterogenous nature of these studies means that conclusions about the precise nature of the dose–response relationship are difficult to draw.23
In addition to gaseous emissions, volcanic eruptions release vast quantities of particulates into the atmosphere with consequent effects on air quality. Heavy ash falls occurred over 100 km from the Mt Helena eruption site with concentrations of respirable particulates in places reaching in excess of 30 times the level normally associated with significant harm21. Transient increases in emergency department attendances and respiratory admissions in those areas with heaviest ashfall were observed,21 and a past history of asthma or chronic bronchitis was the main risk factor for developing respiratory symptoms.25 Overall, despite the high concentrations of particulates measured in this instance, the health effects of the volcanic ash cloud appeared to be relatively minor.26 In other populations exposed to much lower levels of volcano derived airborne particulates, no significant excess of respiratory complaints was observed.27
Dust/building collapse
Although particles larger than 10 µm are usually filtered by the upper airways, particles above this size have been detected in the lungs of New York City firefighters exposed to the dust cloud after collapse of the World Trade Centre.28 This may in part be due to the extremely high density of exposure to these particles in this cohort, but may also reflect the fact that during exertion, mouth breathing is likely to occur, bypassing the filtering system of the nasal airways.29 Studies on rescue workers exposed to World Trade Centre dust have shown that intense exposures of a relatively short duration may cause both acute and chronic health effects. This group have developed high levels of chronic rhinosinusitus, chronic cough, persistent bronchial hyperreactivity and persistent declines in FEV1.29–31 The applicability of these findings to other instances of building collapse is unclear, although acute bronchospasm necessitating hospital admission following dust inhalation after an earthquake has been observed.32
Aspiration/near drowning
A sudden rise in water levels, such as during a tsunami, hurricane or a flash flood, is more likely to directly lead to drowning, aspiration and traumatic injury than a more gradual or predictable rise.33 Both occurrences can, however, cause massive disruption of infrastructure, sanitation and population displacement, with attendant health consequences in the medium to longer term.
Aspiration of water into the lung can lead to the introduction of infection, loss of alveolar surfactant, pulmonary oedema and ARDS.34 Pulmonary oedema is more common in salt water immersion than fresh water.35 In addition, vomiting of swallowed water can lead to the aspiration of gastric contents, especially if consciousness and airway protective reflexes are impaired. Signs of significant aspiration are usually detectable clinically, such that those with no signs of aspiration on presentation—no coughing, normal examination, normal blood gases and normal CXR—have a very low likelihood of developing pulmonary oedema or pneumonia and are unlikely to require further medical intervention.35
Following the 2004 tsunami, near drownings and trauma constituted most of the immediate post-disaster morbidity.36 One medical team reported on 37 patients who had aspirated soil-contaminated salt water.37 Around half of these developed aspiration pneumonia and eight patients developed ARDS (Fig. 2a). Pneumothorax (19%) and pneumomediastinum (8%) also occurred as a later complication in those receiving ventilatory support.37,38
The infective sequelae of near drowning reflect the microbial flora of the aspirated water. Different organisms may predominate in freshwater and saltwater aspirations, but aerobic Gram-negative bacteria, including pseudomonas and pseudomonas-like species, are often reported.34,39 In addition, colonizers of the oropharynx, such as streptococcus pneumoniae, staphylococcus aureus and anaerobes, may translocate to the lung during aspiration and cause infection. In one series, the majority of organisms isolated from blood or sputum culture of victims of the 2004 tsunami were Gram-negative bacteria, and included cases of Burkholderia pseudomallei, which causes melioidosis and is endemic in South-East Asia.37 As such, antibiotic therapy may need to include agents active against pseudomonas and any locally prevalent organisms. Antibiotics should be instituted in patients with fever, pulmonary infiltrates and/or signs of systemic toxicity.39 Although these signs can develop post aspiration in the absence of pneumonia,35 a conservative approach is warranted given the high morbidity associated with this complication and the likelihood of aspiration of contaminated water in most disaster settings. Fungal infection can also complicate near drowning and should be considered in patients not responding to antibacterial therapy, in those who develop pneumonia some time after the acute aspiration and in those who develop brain abscess or meningitis.39 Both pseudallescheria boydii and aspergillus species have been reported in this situation.39–41
Respiratory infections, alongside enteric infections, also predominate in the weeks following a flood or tsunami,42–44 reflecting a number of factors in addition to direct water borne carriage of pathogens, including population displacement, overcrowding and poor nutritional status. In addition, moulds may contaminate wet buildings following hurricane or flood damage, causing respiratory illness in susceptible individuals.45
Trauma is a major cause of morbidity and mortality in a number of different disaster scenarios but it is the predominant mechanism of injury following earthquakes46,47 and constitutes the majority of earthquake-related hospital admissions in the first 24 h.46 The very young and the very old have the highest risk of mortality from an earthquake.48,49 Chest trauma is present in around 10% of earthquake casualties who present to hospital32,50,51 and management may be complicated by delays of several hours or even days in extricating some of those trapped under the rubble.32,51 (Fig. 2b) Chest injury is often accompanied by injuries to other organ systems and multiple injuries are associated with increased mortality.50
Excluding superficial abrasions to the chest, the spectrum of injuries seen in those with chest trauma following earthquakes includes: rib fracture (17–50%), which may be complicated by flail chest, pneumothorax (6–52%), haemothorax/haemopneumothorax (11–19%), subcutaneous emphysema (10%), pulmonary contusion; rupture of cardiovascular system and diaphragmatic rupture.32,50,51 In addition, pulmonary embolism and pneumonia may complicate chest trauma, and ARDS and renal failure can develop in those with severe polytrauma or crush injuries.
Management of the trauma patient should follow in accordance with the advanced trauma life support (ATLS) guidelines and is beyond the scope of this review.52 In addition to immediate airway management and cardiovascular support, tube thoracostomy is one of the most important thoracic interventions in the acute setting.47 Tube thoracostomy was the second most common procedure (behind fasciotomy) performed in one hospital following the 1999 earthquake in Turkey, occurring in 34/263 (13%) of patients.46
Natural disasters are times of immense psychological stress. Acute psychological reactions are ubiquitous following a natural disaster and may develop into symptoms resembling post-traumatic stress disorder (PTSD) and depression within days of the acute event.53 Physical manifestations of these disorders can occur and respiratory symptoms attributable to stress ranging from relatively simple anxiety syndromes through to PTSD can occur in victims, survivors and, importantly, in rescue and aid workers. For example, one-third of firefighters have been described as developing PTSD-like features following a bushfire disaster.54
- Top of page
Communicable respiratory diseases
Communicable diseases, including those of the lung, commonly emerge following disasters. This occurs due to population displacement, poor availability of safe water and sanitation facilities, overcrowding and the non-functional state of health-care services in affected areas. These are often compounded by a poor underlying health and low vaccination status of the affected population55
Overcrowding is a common problem in populations displaced by natural disaster and may facilitate the transmission of communicable diseases, particularly respiratory and gastrointestinal diseases. Loss of housing forces people into emergency shelters, tents, community building with limited daily living support. The World Health Organization recommends 30 m2 living place per person-plus the necessary land for communal activities, agriculture and livestock-as a minimum overall figure for planning a camp layout. Of this total living space, 3.5 m2 is the absolute minimum floor space per person in emergency shelters.56 Beds and mats should be separated for a minimum distance of 0.75 m.57,58 These requirements unfortunately cannot be fulfilled when the disaster affects developing countries with limited capacity to respond, leading to increased frequency of respiratory infections. In addition, these infections are often severe as lack of access to health services and to antimicrobial agents for treatment increases the risk for death from acute respiratory infection (ARI) following disasters.
Acute respiratory infections are a major cause of illness and death among displaced populations and often occur in the first 3–5 days following the emergency.59 Cumulative data from Aceh following the 2004 Indian Ocean tsunami showed that by week 12, 62% of the 184 864 documented consultations were for cases of respiratory infections. Children are often affected in these situations—6599 cases from the above dataset were children less than 5 years of age and 18 613 were children over 5 years of age. A similar situation was recorded in Sri Lanka following the tsunami.60,61
The ARI due to viral diseases in crowded refugee/displaced population settings spreads quickly. Overcrowding is an important pulmonary risk for healthy displaced survivors (Fig. 3a), especially children (Fig. 3b,c) and also for those injured and for those caring for them in makeshift hospitals because of the ease of spread of organisms (Fig. 3d). This can be prevented by reducing the concentration of infectious respiratory aerosols in the air and by reducing the presence of contaminated surfaces and items with the following methods:62
- 1Adequate ventilation to ensure good air flow and prevent increased concentrations of respiratory particles.
- 2Separating infected patients from other patients to reduce the risk of transmission of infection from the source patient to others by reducing direct or indirect contact transmission.
- 3Limiting contact between infected and uninfected people, such as nonessential health-care workers and visitors, which reduces the risk of transmission to susceptible individuals.
- 4Spatial separation (>1 m) between patients including head-to-toe positioning of patient beds if space is limited.
- 5Cleaning and disinfection of contaminated surfaces and items.
Rescuers and health workers may also be at increased risk of ARI. For example, after the 2008 Wenchuan, China earthquake, victims and rescuers lived in close proximity in temporary shelters with crowded conditions with poor ventilation. The rate of ARI among the victims and rescuers that lived in these shelters was very high, particularly acute upper respiratory infections.63
Transmission of pulmonary tuberculosis (TB) is also increased in displaced populations following natural disasters. The transmission of TB is facilitated by recirculation of exhaled air, closeness and duration of contact to persons with TB, low exposure to ultraviolet light and poor nutritional status. This is especially so in children, in whom risk of TB is usually followed by exposure to adult TB64.
Transmission rates can also increase following disasters because victims default from TB treatment programmes, particularly if they are part of a mobile refugee population.65 Thus, it is important to maintain adequate antituberculosis treatment programmes following disasters. Acquired TB drug resistance can also occur post disasters due to poor adherence to treatment, inappropriate prescription, irregular drug supply and poor drug quality. A cluster of four cases of multi-drug-resistant TB in Austria between June 2005 and April 2006 was identified as the transmission arose from single primary case, a 36-year-old Chechen who immigrated illegally to Austria and was relocated in a hostel and had no clinical follow-up visit and no controls of drug intake.66 The lessons learned from Hurricane Katrina, New Orleans 2005 provides an example of how to minimize the risk of transmission of TB—the strategic elements included: (i) supplying 2 weeks or 30 days of medicine to each patient who was likely to relocate; (ii) providing each patient with a personal card listing contact numbers of the TB programme personnel; (iii) sending a list of patient names to the National Tuberculosis Control Association for sharing with programme officials in other states; and (iv) establishing a referral centre.67
Measles can have a major impact on health following disasters, especially those that involve massive population displacements. It is spread by respiratory contact with fluids from an infected person's nose and mouth. The World Health Organization recognizes refugees as one of the highest-risk groups for measles outbreaks. Several outbreaks have been reported among refugees and other emergency settings due to their characteristic massive population displacements, overcrowding, high population densities and low vaccination coverage.60 Other factors include the continuous arrival of new displaced persons, poor vaccination status in the surrounding community, narrow target age group for vaccination campaign, primary vaccination failure due to vaccination in lower age group, lower vaccination coverage in high-risk group, one time measles vaccination strategy, frequent visit of displaced persons between camps, frequent movement of refugees in the neighbouring community and in other camps, malnutrition and famine, insecurity and inability to target zones, no or limited surveillance system, lack of laboratory confirmation of suspect cases and association with other diseases. Following the eruption of Mount Pinatubo in the Philippines in 1991, measles accounted for 25% of the morbidity and 22% of the mortality among the more than 100 000 people displaced. As expected, the high morbidity and mortality rates in that group were attributed to crowding and very low immunization coverage plus cultural barriers to care.68 The experience amongst displaced persons in Sudan is similar, with measles accounting for 53% of deaths, with the highest proportion occurring in children. Because international agencies are now implementing measles vaccine campaigns in emergency settings and camps, measles outbreaks have been less frequently reported since 1990.69 Kouadio et al. suggest that control of measles in displaced population settings can be achieved by a vaccination campaign based on a combination of local epidemiological factors, targeting the priority age group of 6 months to 5 years, extending then to 15 years and older only if the budget allows it. They also suggest giving measles vaccine together with vitamin A supplements to malnourished children (100 000 UI on day 1 and day 2 for children aged 6 months to 12 years and 200 000 UI on day 1 and day 2 for those aged >12 years), vaccinating refugees immediately upon arrival in camps, promoting simultaneous vaccination campaigns within all refugee populations in neighbouring camps plus the surrounding host community population, as well active case detection to supplement passive surveillance for early case detection for rapid response and appropriate treatment for infectious complications (pneumonia, severe diarrhoea, encephalitis and severe malnutrition).70
Collapse of health systems following natural disasters
Local health-care provision is often compromised following disasters (Fig. 4). This might be because of destruction of the health facilities, death or injury of staff, destruction of supplies of medications and equipment and loss of power and water supply. Following the 2004 tsunami, 53 of 244 health facilities in Aceh province were destroyed or severely incapacitated and 42 of 481 health professionals died.60 Furthermore, other facilities were rendered non-functional for weeks because of the mud and debris that filled them. In addition, health-care staff were often understandably 'distracted' by the need to find and care for their own families. Thus it was difficult to provide the population with medical services in hospitals and in primary health cares. In Sri Lanka, 92 health facilities, including 35 hospitals, were destroyed by that tsunami and in the Maldives, one regular hospital, two atoll hospitals and 20 health centres were destroyed.59,71 In 2007, an earthquake off the coast of Peru caused significant damage to 24 (60%) of the regional health facilities with 10% completely destroyed, 13% with significant damage (defined as repairable, but with at least partial collapse of walls or roof) and 38% intact with some structural damage (defined as having cracks or shifts in the walls or foundation). However, as was learnt in Haiti following the 2009 earthquake, cracks in health facilities can appear benign but may actually render the building vulnerable to collapse in subsequent tremors, that is, health-care delivery remains delayed until structural inspections by experts can be completed and support provided where needed.72
Natural disasters may also impact on pre-existing respiratory diseases by disrupting the treatment of chronic respiratory problems, for example, via loss of power for those requiring oxygen or nebulizations, by destroying health services and infrastructural and by removing access hospitals and clinics, for example, for physiotherapy and early intervention for disease exacerbation.71
Disaster preparedness and respiratory disease
Although respiratory conditions are common post disaster, the treatment required to manage them is often absent. A necessary part of an effective response to any natural disaster is having the required equipment and pharmaceuticals that are needed to manage and treat the resulting conditions that will predictably occur. This is difficult in developed countries, where health-care logistic systems have moved to 'just-in-time' supply, which, while both efficient and fiscally responsibly in normal operations, leaves little redundancy.73 Having medical caches within hospitals are both burdensome and difficult to maintain. National stockpiles can take up to 36 h to be delivered, as demonstrated during Hurricane Katrina in 2005.74
In respiratory disease in disasters, there is a requirement for supplies of equipment and medications for both acute and chronic disease. The exact requirements will vary, depending on the type of disaster, the climatic conditions, the vaccination status and the general health of the population. Respiratory drugs were the most commonly used drugs post the 2003 Bam earthquake in Iran, albeit in a cold and poor sheltered environment,75 while acute respiratory diseases made up between 13 and 25% of all consultations in the first 5 weeks post the 2004 Asian tsunami.76
The types of medications and equipment required to be stockpiled for a natural disaster is less clear, but are often focused on ARI. Various reviews have highlighted that the medications required should be a mix of pharmaceutical agents designed to treat both the acute repiratory infections, which are common after many types of disasters, and exacerbations of chronic repiratory diseases.77 Following Hurricane Andrew in 1992, field hospitals were reporting depletion of all their antibiotics within 24 h.78 Drugs for more chronic respiratory diseases, including asthma and chronic obstructive pulmonary disease, become increasingly important, particularly as the ARI recede. Following the eruption of Mt Pinatubo in the Phillipines, the majority of medications dispensed to the 20 000 evacuees were for chronic medical conditions.79
The research on what medications should be stockpiled is less clear. Apart from basic antibiotics the stockpiles may need to include a range of antibiotics, such as imipenem, ciprofloxacin, azithromycin and vancomycin, to treat unusual pathogens seen in near drownings from tsunami and floods.76 Bronchodilators may be required acutely for exacerbations of asthma or isolated cases of bronchospasm, which may be related to smoke inhalation from bushfires.80 A review of data from the 2004 National Hospital Ambulatory Medical Care Survey in the USA identified that the most likely chronic respiratory disease requirements for a disaster were bronchodilators, oral steroids and antibiotics.81
Given the critical care demands, the stockpiling of ventilators, particularly for traumatic injury post disaster, is certainly recommended, although little is known about the success of such stockpiling.82 Given that there will be a number of roles for these ventilators, including movement from the scene, movement between hospitals and in-hospital care, any stockpile should have a mix of both transport and critical care ventilators.82 Other equipment is more readily available in the hospitals, but stockpiles of thoracostomy trays, for tube or needle thoracostomy procedures, for thorax injuries in earthquakes particularly, may be useful.47
Transport of respiratory patients after disasters
Transport of any respiratory patients post disaster will depend on the various modalities of transport and the priority of the patients. In large countries like Australia, where the event has occurred outside a major urban centre, this transport will principally be by aeromedical evacuation. This may be by rotary wing aircraft, if the disaster is relatively close to a city, or by fixed wing aircraft, if it is more remote. Apart from military aircraft, most medical evacuation aircraft are small, only usually able to take a maximum of two critically ill patients. Military aircraft, such as the C-17 or C-130, while able to carry many more patients, are a limited resource. In addition to limited availability, they are often limited as to what airstrips they can land at and the availability of critical care staff.83
In many developed countries, there are well-established protocols for activating and using military aeromedical evacuation teams in mass casualty incidents. These teams need to be activated early, are highly trained and are generally equipped to the level of a mobile critical care facility.84 Their focus is on advanced airways management and respiratory support, including oxygen and mechanical ventilation, as well as haemorrhage control and careful monitoring.84 Such transport, while important for patient care, may have a significant associated risks, with up to 34% of patients reported having an adverse event.85 The transport of critically ill mechanically ventilated patients by helicopter, however, is rarely associated with major adverse events, although there may be a greater risk of minor adverse events on longer fixed-wing flights.86
There are significant challenges, particularly with respiratory patients, on longer flights. Oxygen supplies are limited and patient management must include planning for expected consumption and patient deterioriation.87 Electrical power is often restricted, including battery life, which may impact on the monitoring of a patient in a noisy environment and the availability of diagnostic tests, and the physiological impacts of the decrease in ambient pressure (usually equivalent to 2000 to 2500 m a.s.l.), low humidity and the acceleration and deceleration of the aircraft need to be factored into the management of the patient, even when ventilated.88 With good planning and proper management, however, most respiratory patients, including acute respiratory distress syndrome patients, can be adequately ventilated and oxygenated, even on long flights.88
- Top of page
In conclusion, pulmonary problems are major causes of morbidity and mortality following natural disasters. It is therefore vital that disaster preparedness and response teams are aware of these problems. Pulmonologists are well placed to provide advice and training to such teams. Such training programmes, which are usually administered by professional medical societies, government bodies or non-government organizations, typically welcome the assistance of pulmonologists in informing disaster response teams of the range and management of the pulmonary diseases listed above and, where feasible and appropriate, helping serve on such teams.
- Top of page
- 1Bushfires: are we doing enough to reduce the human impact? Occup. Environ. Med. 2002; 59: 215–6..
- 2Burn injuries in the 1995 Hanshin-Awaji earthquake. Burns 1997; 23: 319–22., , et al.
- 3Management of acute smoke inhalation injury. Crit. Care Resusc. 2010; 12: 53–61., , et al.
- 4The influence of inhalation injury and pneumonia on burn mortality. Ann. Surg. 1987; 205: 82–7., , .
- 5Effect of inhalation injury, burn size, and age on mortality: a study of 1447 consecutive burn patients. J. Trauma 1994; 37: 655–9., , et al.
- 6
- 7Wood smoke: emissions and noncancer respiratory effects. Annu. Rev. Public Health 1994; 15: 133–56., .
- 8Inhalation injury, pulmonary perturbations, and fluid resuscitation. J. Burn Care Res. 2007; 28: 80–3., .
- 9The plain chest radiograph after acute smoke inhalation. Clin Radiol. 1988; 39: 33–7., .
- 10The 1997 haze disaster in Indonesia: its air quality and health effects. Arch. Environ. Health 2002; 57: 16–22., , et al.
- 11Wildfire air pollution and daily mortality in a large urban area. Environ. Res. 2006; 102: 29–35., .
- 12Impact to lung health of haze from forest fires: the Singapore experience. Respirology 2000; 5: 175–82..Direct Link:
- 13Asthma presentations to emergency departments in western Sydney during the January 1994 Bushfires. Int. J. Epidemiol. 1996; 25: 1227–36., , et al.
- 14Health effects of the 2003 Southern California wildfires on children. Am. J. Respir. Crit. Care Med. 2006; 174: 1221–8., , et al.
- 15The impact of smoke on respiratory hospital outcomes during the 2002–2003 bushfire season, Victoria, Australia. Respirology 2009; 14: 69–75., , et al.
- 16Ambient biomass smoke and cardio-respiratory hospital admissions in Darwin, Australia. BMC Public Health 2007; 7., , et al.
- 17Air particulate pollution due to bushfires and respiratory hospital admissions in Brisbane, Australia. Int. J. Environ. Health Res. 2006; 16: 181–91., , .
- 18Impact of haze from forest fire to respiratory health: Indonesian experience. Respirology 2000; 5: 169–74..
- 19Forest fires, air pollution, and mortality in southeast Asia. Demography 2002; 39: 1–23..
- 20Deaths during the May 18, 1980, eruption of Mount St. Helens. N. Engl. J. Med. 1981; 305: 931–6., , et al.
- 21Mount St Helens eruptions, May 18 to June 12, 1980. An overview of the acute health impact. JAMA 1981; 246: 2585–9., , et al.
- 22Pyroclastic flow injury. Mount St. Helens, May 18, 1980. Am. J. Surg. 1982; 143: 565–8., , et al.
- 23Health hazards from volcanic gases: a systematic literature review. Arch. Environ. Health 2004; 59: 628–39., .
- 24Acute health effects associated with exposure to volcanic air pollution (vog) from increased activity at Kilauea Volcano in 2008. J. Toxicol. Environ. Health A 2010; 73: 1370–81., , et al.
- 25Mount St. Helens eruptions: the acute respiratory effects of volcanic ash in a North American community. Arch. Environ. Health 1983; 38: 138–43., , et al.
- 26Evaluation of physical health effects due to volcanic hazards: human studies. Am. J. Public Health 1986; 76: 66–75., , et al.
- 27Health effects of volcanic ash: a repeat study. Arch. Environ. Health 1990; 45: 367–73., , et al.
- 28Induced sputum assessment in New York City firefighters exposed to World Trade Center dust. Environ. Health Perspect. 2004; 112: 1564–9., , et al.
- 29Upper and lower respiratory diseases after occupational and environmental disasters. Mount Sinai. J. Med. 2008; 75: 89–100., , et al.
- 30Persistent hyperreactivity and reactive airway dysfunction in firefighters at the World Trade Center. Am. J. Respir. Crit. Care Med. 2003; 168: 54–62., , et al.
- 31Lung function in rescue workers at the World Trade Center after 7 years. N. Engl. J. Med. 2010; 362: 1263–72., , et al.
- 32Thorax and lung injuries arising from the two earthquakes in Turkey in 1999. Chest 2001; 120: 1163–6., , et al.
- 33Health impacts of floods. Prehospital Disaster Med. 2010; 25: 265–72., , et al.
- 34
- 35Pulmonary oedema, pneumonia and mortality in submersion victims; a retrospective study in 125 patients. Intensive Care Med. 1996; 22: 101–7., , et al.
- 36
- 37Treatment of survivors after the tsunami. N. Engl. J. Med. 2005; 352: 2654–5., , .
- 38Respiratory complication of tsunami victims in Phuket and Phang-Nga. J. Med. Assoc. Thai. 2005; 88: 754–8., , et al.
- 39Pneumonia associated with near-drowning. Clin. Infect. Dis. 1997; 25: 896–907., .
- 40Invasive pulmonary aspergillosis after near-drowning. Intensive Care Med. 1984; 10: 203–4., , .
- 41Near-drowning complicated by brain abscess due to Petriellidium boydii. Arch. Neurol. 1982; 39: 511–3., , et al.
- 42Post-flood—infectious diseases in Mozambique. Prehospital Disaster Med. 2002; 17: 126–33., , et al.
- 43Prehospital care of tsunami victims in Thailand: description and analysis. Prehospital Disaster Med. 2006; 21: 204–10., , et al.
- 44The impact on health and risk factors of the diarrhoea epidemics in the 1998 Bangladesh floods. Public Health 2002; 116: 68–74., , et al.
- 45Center for Disease Control and Prevention. Mold prevention strategies and possible health effects in the aftermath of hurricanes and major floods. MMWR 2006; 55., , et al.
- 46Medical experience of a university hospital in Turkey after the 1999 Marmara earthquake. Emerg. Med. J. 2005; 22: 494–8., , et al.
- 47Earthquakes and trauma: review of triage and injury-specific, immediate care. Prehospital Disaster Med. 2008; 23: 195–201., , et al.
- 48Earthquake mortality in Pakistan. Disasters 2010; 34: 176–83., .
- 49Disaster epidemiology and medical response in the Chi-Chi earthquake in Taiwan. Ann. Emerg. Med. 2001; 38: 549–55., , et al.
- 50Analysis of chest injuries sustained during the 1999 Marmara earthquake. Surg. Today 2002; 32: 769–71., , et al.
- 51Profile of chest injuries arising from the 1995 southern Hyogo Prefecture earthquake. Chest 1996; 110: 759–61., , et al.
- 52American College of Surgeons Trauma Programs. [Accessed 31 Jan 2011.] Available from URL: http://www.facs.org/trauma/index.html
- 53The extent and impact of mental health problems after disaster. J. Clin. Psychiatry 2006; 67 (Suppl. 2): 9–14., .
- 54Physical symptoms in post-traumatic stress disorder. J. Psychosom. Res. 1994; 38: 715–26., , et al.
- 55Epidemics after natural disasters. Emerg. Infect. Dis. 2007; 13: 1–5., , .
- 56Public health in the aftermath of disasters. BMJ 2005; 330: 1379–81..
- 57Epidemiological surveillance after natural disaster. Pan American Health Organisation Scientific Publication. 1982; 420: 48..
- 58Population density and spatial differentials in child mortality in Zimbabwe. Soc. Sci. Med. 1997; 44: 413–21..
- 59Moving beyond the tsunami—the WHO story, Chapter 1: The emergency and its aftermath. pp. 6–39. [Accessed 11 Oct 2010.] Available from URL: http://whqlibdoc.who.int
- 60Epidemic-prone disease surveillance and response after the tsunami in Aceh Province, Indonesia. Wkly Epidemiol. Rec. 2005; 80: 160–4.
- 61Medical needs of tsunami disaster refugee camps. Fam. Med. 2005; 37: 422–8., , et al.
- 62Pandemic influenza preparedness and mitigation in refugee and displaced populations. WHO guidelines for humanitarian agencies. World Health Organisation, 2008., , .
- 63Public health status and influence factors after 2008 Wenchuan earthquake among survivors in Sichuan province, China: cross-sectional trial. Public Health 2010; 124: 573–80., , et al.
- 64Risk factors for tuberculosis infection in children in contact with infectious tuberculosis cases in the Gambia, West Africa. Pediatrics 2003; 111: e608–14., , et al.
- 65Epidemiology and infection in famine and disasters. Epidemiol. Infect. 1991; 107: 241–51..
- 66An outbreak of multidrug-resistant tuberculosis among refugees in Austria, 2005–2006. Int. J. Tuberc. Lung Dis. 2008; 12: 1190–5., , et al.
- 67Integrated preparedness for continuity of tuberculosis care after Hurricanes Gustav and Ike: Louisiana and Texas, 2008. Public Health Rep. 2010; 125: 518–9., , et al.
- 68
- 69Communicable diseases in complex emergencies: impact and challenges. Lancet 2004; 364: 1974–83., , et al.
- 70Measles outbreaks in displaced populations: a review of transmission, morbidity and mortality associated factors. BMC Int. Health Hum. Rights 2010; 10: 5., , .
- 71Disaster risk reduction through strengthened primary health care. WHO Reg. Health Forum 2009; 13: 29–34., .
- 72Impact of the 2007 Ica earthquake on health facilities and health service provision in southern Peru. Prehospital Disaster Med. 2009; 24: 326–32., , et al.
- 73Surge capacity for healthcare systems: a conceptual framework. Acad. Emerg. Med. 2006; 13: 1157–9., , .
- 74Hospital impact: long term issues. In: PowersRB, DailyEK (eds) International Disaster Nursing. Cambridge University Press, Cambridge, 2010; 119–38., , et al.
- 75The pattern of drug prescription and utilization among Bam residents during the first six months after the 2003 Bam earthquake. Prehospital Disaster Med. 2009; 21: 396–402., .
- 76Health impact of the 2004 Andaman Nicobar earthquake and tsunami in Indonesia. Prehospital Disaster Med. 2009; 24: 493–9., .
- 77
- 78Pharmaceuticals in disasters. In: HoganDE, BursteinJL (eds) Disaster Medicine. Lippincott Williams & Wilkins, Philadelphia, PA; London, 2002; 34–40..
- 79Pharmaceutical services to evacuated U.S. military dependents. Am. J. Hosp. Pharm. 1992; 49: 2474–6., .
- 80The 1987 forest fire disaster in California: assessment of emergency room visits. Archives Environmental Health. 1990; 45: 53–8., , .
- 81Evidence-based approach for disaster preparedness authorities to inform the contents of repositories for prescription medications for chronic disease management and control. Prehospital Disaster Med. 2008; 23: 447–57., , et al.
- 82Surge capacity mechanical ventilation. Respir Care. 2008; 53: 78–88; discussion —90., , et al.
- 83Hospital impact: internal disasters. In: PowersR, DailyEK (eds) International Disaster Nursing. Cambridge University Press, Cambridge, 2010; xxiii, 614 p..
- 84Large-scale air-medical transport from a peripheral hospital to level-1 trauma centers after remote mass-casualty incidents in Israel. Prehospital Disaster Med. 2009; 24: 549–55., , .
- 85Quality of interhospital transport of critically ill patients: a prospective audit. Crit. Care 2005; 9: R446–51., , et al.
- 86Adverse events during rotary-wing transport of mechanically ventilated patients: a retrospective cohort study. Crit. Care 2008; 12: R71., , et al.
- 87The support of severe respiratory failure beyond the hospital and during transportation. Curr. Opin. Crit. Care 2006; 12: 43–9., .
- 88Clinical review: critical care transport and austere critical care. Crit. Care 2008; 12: 207., , .


text:
09/04/2008, Daytona Beach, Florida
Some of my family members and close friends know that I've been thinking about throwing in the towel in another month or so after coming 1000 miles down the Chesapeake and ICW and then sailing the Bahamas. I've had a lot of mixed feeling about whether I can really cruise a sailboat by myself with two golden retrievers indefinitely. Technically, I can, but in certain other respects, I'm not sure it is something I want to do for a year or more straight. 3 months cruising alone is one thing, a year or more is another thing. Having an end date for the cruise really helps me mentally at this point even if that date is not very cemented. Maybe it would be better to cruise with a mate. On that note, word on the street is that somebody has bought a ticket to West Palm in a little over a week and will be joining me for almost three weeks of Florida and Bahamas cruising. More about that later. As for my long term plans, I don't know. Maybe I will get off the boat after sailing in the Bahamas and maybe we'll continue on. Time will tell. Even when we stop sailing, we'll have to rent a car and get back to Oriental, North Carolina, where the motorhome is stored. Then we might as well do some road touring, perhaps through the Rocky Mountains if its not too late in the season. Who knows? Thankfully we are cruising now and I wouldn't want to be doing anything else right now and the mornings are getting cooler and the sun is setting earlier and I think we are all enjoying ourselves (and eating well) here on Tropical Dreamer.
09/04/2008, presently we are in Daytona Beach, Florida
Well it looks like hurricane Hanna is going to pass us a couple of hundred miles to the east so I can think about moving onwards instead of hunkering down here. As a naturalist cruising destination, Daytona is about as sucky as it gets. Nothing beautiful that I could find - only commercialism and not even much of that near the City Marina - probably more shops closer to the Atlantic beach. I don't even like shops, except grocery and ABC stores, but I thought it would be fun to browse. There is, however, a nice park close to the anchorage where I've taken the dogs and where I can let them run around supervised with leashes off. I also dingied by myself to shore to get a few things from West Marine like a Quarantine flag and a Bahamas courtesy flag. I canceled my marina reservation and I'm going to head on to an anchorage within walking distance of the beach later this afternoon. There is another cane coming our way next week, but there's little I can do about that now. The wind turbine is loving this weather and the breeze feels nice. Tomorrow is supposed to be the bad day when the hurricane is directly opposite us at sea so I'll likely be holed up in the cabin for that.
After taking the dogs to the beach and returning in near darkness in the dingy at full speed with an incredible view of the first sliver of moon, I made the nice dinner you see here. This was one of those cruising evenings that makes it all worthwhile. Dessert of Rollos. Nice.
09/02/2008, Fort Matanzas Inlet
By the way, "Matanzas" means slaughter. One happened here when some French tried to come through the inlet. Hopefully nothing like that tonight. However, in a few days hurricane Hanna will be coming north along the Florida coast. It is supposed to hit land just north of here (ironically) but the reports today predicted very heavy winds Thursday and Friday for my area. I've decided that I'm not coming off the water - not just yet at least. Instead I reserved space at a nice marina in Daytona Beach for the duration of the storm. We will ride it out at the dock in air conditioned comfort. I see lightening in the distance tonight - hopefully it won't come our way. I only have a medium amount of chain out as this is rather narrow channel and we are closer to shore than I would like. The change of tide takes us pretty close to shore near the fort and another one is coming in the middle of the night. I think I'm ok, but it will be low tide on that change and when I swing the other direction it is possible that I will ground - I think I'll be ok. On that note, I kind of hit an ICW marker while down below for a minute making a sandwich. It was on the way from St. Augustine to here and I checked before left the helm but I must not have seen this one after so many hundreds of the blessed things. Amazingly, the Catalina 36 pretty much just bounced off without problem. I'm certain one of the two signs on the marker fell into the water...so I'm sorry about that and will be even more careful when letting the boat steer itself in inland waters.
09/02/2008, Matanzas Inlet Between St. Augustine And Daytona Beach
I'm anchored in a really cool place tonight. As you may know, Spain controlled Florida and other parts of what is now southern United States from the time Columbus "discovered" the new world in 15th century until the British and then the US took possession. The forts that the Spanish built are huge - European in their massiveness. In addition to the large fort in St. Augustine,there is a smaller stone fort along the side of this short river leading to a small inlet. The fort was constructed to prevent back-door sea access to St. Augustine. Crews and supplies from the main fort there were dispatched here to guard this inlet. There is a really nice beach on the inland waterway side (rare) that I dingied to with the dogs around dusk. This place is just dripping with history and we are docked less than 100 yards from the fort. People have been camping out in this otherwise isolated inlet for literally hundreds of years. Tonight it is just Jake and Anne and myself.
09/02/2008, St. Augustine
I woke and when it got light out I was treated to this sight. Cleaned up the boat. Cleared out the rear cabin and checked the raw water strainer and packing gland, both of which appeared fine. Took the dogs for a long walk. Motored to the marina and filled up with diesel and water. Headed south. Traveled about 15 miles to this short river inlet where I'm presently anchored and getting ready to take the dogs to the beach. Met a nice guy last night (who I helped get his no-motor dingy to another boat). He called me over to his boat around sunset for a beer. This guy was living on a boat that I wouldn't spend a single night on. No electricity, bathroom, no anything. Just a place to sleep on the water. Yet he had me over for a beer for helping him get up-current to another boat. It really made me appreciate the absolute luxury I live in while on Tropical Dreamer. Aside from the cush interior, I have electricity, a working head, refrigeration, navionics, cleanliness, storage, full kitchen, fuel and water supplies for a week or two, so much more. I am so fortunate and I forgot how lucky I am to be traveling this way.
09/01/2008, St. Augustine, Florida
We are spending the day hanging out in St. Augustine and figuring out whether to continue on or not. It appears that tropical storm Hanna's wind and rain will arrive here Thursday or Friday and will be mild to worse. If I head south I just head into it. Yet I really don't want to hang around five days waiting for a storm like I did in Hilton Head (though this is not a particularly bad place to wait it out). Again, if there is a time to take a break it is now. I just don't know whether doing so is smart or stupid since I am so close to the Bahamas, whatever that means.
I really enjoyed touring the Spanish Fortress, now a Unites States National Monument. They really knew how to build things back in mid-evil times.


text:
february is always the toughest month for me to get through, even though it's the shortest. winter's charm has worn out and my mind turns entirely to spring. i have a family house at the beach and i don't spend much time there in the winter, so by now i start to feel it calling to me…my heart aching for sand and surf and most of all sun. driving to the shore with the windows down and that familiar salt water smell as you near the ocean.
the need for spring and summer takes over my thoughts and each day that winter drags on feels more and more unbearable. i'm trying to fight the blues this month… jemma and i each put together a little survival kit of things that help us get through the waning days of winter!
here's mine:
i've been in my apartment for over a year and i still don't have a couch! time to fix that – i like the sixties look of this one. while the snow piles up outside i'll put on some bob marley (catch a fire or burnin') and break out the watercolors- getting into a hobby always helps when i'm cooped up inside. i love these little shorts that i can wear now with tights and in summer with flip flops to the beach! and i'm eyeing a backpack for the vacation i'm planning sometime soon – hopefully to somewhere warm! my next book, favorite lip balm, and this amazing hat, will come with me.
and from jemma:
February is here and Valentine's Day isn't that long away, I sure need some love to help me through this dreary month.
The cold weather is getting to be a little too much. This month I intend to indulge in my comfort zone – cozying up at night with welsh wool tapestry blankets burning one of my favorite scented candles, Baies by Diptyque, while I watch romantic comedies.
To make this month romantic I might add lace to my wardrobe (pictured are the fp-1 anita page slip with pacifica crochet hoodie and long sleeve henley lace bodysuit) and I would love to get hold of these Stella McCartney postcard panties – being from the UK these suit my thoughts "with love from London" with Big Ben printed embroidered on the front.


text:
NEW PORT RICHEY — Many people don't give a second thought about the negative impact on the environment when they don't properly dispose of our trash.
About a year ago, Pasco County Environmental Lands adopted the mile of road to the county's Eagle Point Park. The department conducts four cleanups a year on the road along Trouble Creek Road and Strauber Memorial Highway.
Thirteen volunteers from River Ridge High School and elsewhere took part in the latest cleanup last Saturday.
By noon, the workers had collected 20 trash bags and three recyclable bags of litter, as well as two televisions, a doghouse and a box spring mattress. One of the most unusual pieces of garbage that was found was live ammunition.
Volunteers got encouragement from drivers thanking them for their work.
Cristina Esposito, the Pasco County environmental lands program coordinator, was one of the supervisors for the cleanup.
"The primary reason we did Adopt-A-Road is because there is so much trash in this area. We could be cleaning it up today and next week there could be trash." Esposito said. "We thought it would be a good idea to do more frequent cleanups here."
While picking up garbage, volunteers also learn about the plants that they see along the way. "We do a bit of sneak environmental education," Esposito said.
River Ridge student Jonathon Damato believes that they accomplished so much because all of the volunteers worked together. "Teamwork is essential in a roadside cleanup" he said.
Many of the volunteers from River Ridge became involved through the school's SPLASH club, which stands for Students Protecting Land and Sea Habitats. Club members assist in many cleanups and recycling programs.
Hannah Fahsbender, a high school seniorand president of the SPLASH club has done more than 10 cleanups in the last four year. "I'm gaining knowledge about what's actually happening and what we can do to fix that." Hannah said.
She believes that people need to be more aware of how they are affecting the environment with garbage. "This is where we live. This is planet Earth and we are hurting it by littering."
The next cleanup on April 12 will cover a two-mile radius taking in the county's J. Ben Harrill Recreation Complex, in Holiday. Volunteers of any age are welcome.
For more information go to http://pascocountyfl.net and click on the Environmental Lands Department link or call (727) 847-8140.


text:
Rest Easy, Bill: After 4,000 Clinton Jokes, Leno's Run Wraps Up
By editor • Feb 6, 2014
Originally published on February 6, 2014 6:55 pm
Thursday marks Jay Leno's last night hosting The Tonight Show on NBC. He's told a lot of jokes over the years, but his most common target has been Bill Clinton — so says a study from the Center for Media and Public Affairs at George Mason University. Professor Robert Lichter explains why he's spent more than 20 years of his life cataloging late night TV jokes.


text:
The Fury combines horror and science fiction with the conventions of the suspense-thriller genre.
Gillian Bellaver is from one of the wealthiest and most powerful families in the world. Robin Sandza's father, Peter, is one of the United States government's deadliest assassins.
Gillian and Robin are from two different worlds. Outside they have nothing in common. Yet they are spiritual twins, possessors of a horrifying psychic energy that threatens humanity.
While dangerous and fanatical men vie for the secrets of their awesome power, Peter Sandza, using all the ruthless skills of his trade, makes a final desperate effort to save them.
But Peter himself is possessed - by a fate as implacable and as deadly as the powers of the children he is committed to protect.
The Fury was the basis for the 1978 film directed by Brian DePalma with a screenplay by the author.
©2008 Penny Dreadful, LLC (P)2012 David N. Wilson
"One you will want to listen to several times"
It deals with an interesting subject and consequences of it.
The idea of reincarnation and being with particular people over and over again in different lives, about traveling in a place where many humans fear to go and about the relationships of those that can exist sometimes with our conscious and/or unconscious minds. It was a very intriguing story of two souls who have been together in various types of relationships but always together in all their past lives and how they decided how to be together in the present one as brother and sister. However, due to a delivery problem, one soul is born and the other soul is displaced and must find another body so they can be born together. The births of both occur during a astronomical and astrological alignment that makes them special. As they grow older, they are connected not as twins as we know it but as spiritual twins. There is a lot of detail in the story but you may not catch all of in one reading. It is one of those stories that when you listen to it again, you learn something new. It also illustrates very well not only the closeness of the two involved, but of more sinister and insidious powers that would use this power for their own gain and rise to power. It is a remarkable story of the journey of thees two young teenagers and the adults around them and the danger that one is in when he no longer acts accordingly.
Very detailed and well written. It was probably one of the first really good stories regarding psychic ability and what can happen as a result of powers that be infuriate one of them.
This is the first book I have listened to that he has done, but I really liked his narration. His voice is soft and soothing but he makes clear, as well as the way John Farris wrote the different personalities, to know who was who. I am sure if he were to do it over, he might add some things to it like amplifying the different personalities, but I think he did a great job.
Because the actual "damage" or harming has to do with the strong emotion of anger in some situations but not all, it would be difficult to find another title. You begin to understand just what the fury is and what can bring it about. I thought maybe something along the lines of "The Twin Souls" or "Spiritual Twins" but it sounds like a metaphysical type book.
It took a second listen to understand that the two main characters were always connected to each other, then one forgets while the other doesn't until much later. Gillian is from a very wealthy and power family however, they do not make her a snob or have a feeling of entitlement and she is a very compassionate and empathetic girl of privilege, but in no way spoiled or self centered. It shows how uncommonly kind some in her "crowd" are. Robin is not a child of privilege but it happy nonetheless because of his relationship with his father. It was also good that these kids were not just two stupid, naive kids but had an understanding of who and what they are in a way that most of us do not understand. I liked the loyalty the essentially have to each other though one of them becomes so traumatized that it literally drives his insane and in his insanity, he begins to do cruel things to his "twin" and how the other twin desperately tries to find the other in the hopes that they will be revived and become rehabilitated. I also thought the idea of government or private entities using kids like these and discard them after they are finished with them leaving them forever in an unstable state, twisted and burned out.
The relationship between the kid and their "parents" is not one of non concern or pawning them off on other people except in the situation where one is a single parent and needs someone to care for his son while he is "working." In fact, there is a genuine love and concern by the parents towards their children.
One theme I thought was very interesting is that a couple of times in the story either states or infers that instead of seeing kids like this as special, there is no way to assimilate into their society as opposed to more primitive cultures are and yet we think our culture is superior. The basic inference is that people will destroy things it can not understand and I think that describes the more "advanced" societies.
Report Inappropriate Content
If you find this review inappropriate and think it should be removed from our site, let us know. This report will be reviewed by Audible and we will take appropriate action.


text:
Scottsdale Community College has put the old Bill Heard Chevrolet site on the market just four years after buying it for $2.3 million.
SCC bought the 7,000-square-foot building at Pima and McDowell roads in 2010 with the intention of turning it into a training facility for its emergency-management technician and fire-science program, including driving simulators.
But in 2012, in a budget-cutting move, the Maricopa County Community College District consolidated several programs. The first-responder programs went to Mesa Community College and the culinary and hospitality programs were focused at SCC.
The Scottsdale college has used the space to house staff displaced by construction on the main campus, but will soon no longer need it. SCC is hoping revenue from the sale will fund a new project that's in the planning stages.
The college hasn't listed a price for the old car dealership, which went out of business in 2008, but is hoping to recoup what it paid, plus a little more, according to Carl Couch, vice president for administrative services.
The money will go toward creating an "indigenous scholars institute" for study by Native Americans and research into the Indian experience, he said.
SCC is on the Salt River Reservation, on Chaparral Road just east of the Loop 101 freeway.
The institute would be part of a new community center to be built on the campus, possibly starting next year. The community center also would house meeting spaces, student support services and the cafeteria.
Couch said the community center will fulfill a promise made in the original 99-year lease the college signed with the Salt River community in 1970.
"There's a phrase in the lease that calls for a cultural center," he said. "Some people interpreted that to mean that any time you build a college, it's a cultural center.
"But others interpreted it to mean 'Oh, you're going to build a cultural center,' " he said. "We've never reconciled that unrealized expectation."
The college also is planning a new building to house the business and public-safety programs.
The community center and business building would be considered one project and would cost about $13.5 million total, Couch said.
The money would come from the $950 million bond approved by voters in 2004. Scottsdale got about $62 million of that bond, and used it to renovate its library, performing arts center, nursing and information technology buildings and to construct buildings for natural science and the film school as well as add a landscaped center to the campus.
Soon the college will begin renovating a classroom building that was vacated by the nursing program.
A project to convert most of the campus to xeriscaping is almost done.
SCC also has spent bond money on technology and maintenance upgrades, parking-lot improvements and restroom remodels. About $1 million went toward improving athletic facilities, including resurfacing the track, redoing the football field and adding a softball field.
Couch said that when the community center and new business buildings are done, the college will have completed all the bond work.
"Any college administrator will tell you that maintenance is always an ongoing issue, but we will have fulfilled our commitment to the 2004 bond and taxpayers," he said.


text:
Cellular Bioenergetics Webinars
Welcome to our popular monthly Seahorse Bioscience Cellular Bioenergetics Webinar Series featuring key thought leaders discussing their areas of expertise and the Seahorse XF technology. This page lists all of our upcoming and past webinars. You may also view our on-Demand webinars by Research Area.
Register for our webinar series and receive a unique password login that you can use for all future webinars. If you have already registered you just need to Log-in up to 15 minutes prior to the webinar start time.
Next Webinar
Our next webinar has not yet been scheduled. Please check back later for updated information.
Upcoming Webinars
On-Demand Webinars
Metabolomics: Redefining the Role of Fuels in Tumorigenesis
Jared Rutter, Ph.D., University of Utah, UT
Julie Saint-Pierre, Ph.D, McGill University Montreal, Canada
Ajit Divakaruni, Ph.D, University of California, San Diego, CA
May 24, 2016
Metabolic regulation of immunity: Exploring programs that drive immune development and function
Jeffrey Rathmell, Ph.D., Duke University School of Medicine Durham, NC
Russell Jones, Ph.D., McGill University Montreal, Canada
Christoph Hess, M.D., Ph.D., University Hospital Basel Basel, Switzerland
April 27, 2016
Measuring platelet bioenergetic function - from marker to mechanism of disease
Sruti Shiva, Ph.D., Associate Professor, University of Pittsburgh
April 20, 2016
Mineralocorticoid receptor suppresses cancer progression and Warburg effect by modulating miR-338-3p-PKLR axis in hepatocellular carcinoma
Dr. Zhigang Zhang, Professor, State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Medical College of Shanghai Jiao Tong University
March 28, 2016
Characterization of Potential Bioenergetic Medicine Agents
Russell Swerdlow, MD, University of Kansas Medical Center
February 24, 2016
Seahorse Metabolic Analyzers Enable Rapid, Quantitative Measurement of Cellular Bioenergetics
David A. Ferrick, PhD, Chief Scientific Officer, Seahorse Bioscience
January 21, 2016
An MTCH2 pathway repressing mitochondria metabolism regulates haematopoietic stem cell fate
Atan Gross Ph.D., Weizmann Institute of Science, University in Rehovot, Israel
November 3, 2015
Measuring cells' dependency and flexibility on the three most abundant fuels in the body: glucose, glutamine and fatty acids
David Ferrick, Ph.D., Chief Scientific Officer, Seahorse Bioscience
October 21, 2015
Metabolic plasticity in T cell responses: Implications for adaptive immunity
Russell Jones Ph.D., Rosalind and Morris Goodman Cancer Centre, Department of Physiology, McGill University
September 23, 2015
Mitochondrial Control in Health & Disease
Victor Darley-Usmar, PhD, Endowed Professor of Mitochondrial Medicine and Pathology University of Alabama – Birmingham
Marcia Haigis, PhD, Associate Professor, Department of Cell Biology Harvard Medical School
Erika L. Pearce, PhD, Associate Professor Washington University School of Medicine
June 25, 2015
Determine the Metabolic Phenotype of Your Cells Using the XFp Cell Energy Phenotype Test Kit
David Ferrick Ph.D., CSO, Seahorse Bioscience
May 20, 2015
Measuring Functional Metabolism of Tissues in 3D
Jonathan W. Wojtkowiak, Ph.D., Moffitt Cancer Center
November 19, 2014
What's Fueling Mitochondria? Designing and Interpreting Pathway-Specific XF Assays
Ajit Divakaruni, Ph.D., Seahorse Postdoctoral Fellow, University of California, San Diego
August 20, 2014
Abnormal Respiratory Function in Autism Immune Cells
Shannon Rose, Ph.D., Arkansas Children's Hospital Research Institute
July 23, 2014
Metabolomics - Following the Carbons that Fuel Cancer
Ralph J. DeBerardinis, M.D., Ph.D., UT Southwestern Medical Center
Christian M. Metallo, Ph.D., Jacobs School of Engineering, UCSD
Eyal Gottlieb, Ph.D., Beatson Institute for Cancer Research
May 21, 2014
Probe the Metabolic Depths of Tumor Spheroids Using the XFe96 Analyzer
Brian Dranka, Ph.D., Manager of Biology, Seahorse Bioscience
April 30, 2014
Simultaneously Measuring Oxidation of Exogenous and Endogenous Fatty Acids
George W. Rogers, Ph.D., Senior Applications Scientist, Seahorse Bioscience
Ajit S. Divakaruni, Ph.D., Seahorse Postdoctoral Fellow University of California, San Diego
March 26, 2014
The Mitochondrial Connection from Bench to Bedside: Strategies to Prevent, Delay and Treat Alzheimer's Disease
Roberta Diaz Brinton, Ph.D., Professor of Pharmacology & Pharmaceutical Sciences, Biomedical Engineering and Neurology, USC
October 31, 2013
Using the XF Analyzer to measure cellular respiration and glycolysis under hypoxic conditions
George Rogers, PhD , Senior Applications Scientist Seahorse Bioscience
Brian Dranka, PhD , Senior Applications Scientist Seahorse Bioscience
September 25, 2013
Mitochondria - the Powerhouse of the Cell Goes from Bench to Bedside
Victor Darley-Usmar, PhD, Professor Dept. of Pathology University of Alabama at Birmingham
August 28, 2013
Metabolic Adaptations in Fumarate Hydratase Deficient Cells
Christian Frezza, PhD, Hutchison/MRC Research Centre, Cambridge, UK
May 29, 2013
Dissecting the role of energy metabolism and mitochondrial ROS in the familial autoinflammatory disease TRAPS
Martin Pelletier, PhD, NIAMS/National Institutes of Health
April 25, 2013
Assessment of metabolic reprogramming of the skin fibroblasts from patients with mitochondrial diseases using the Seahorse XF Analyzer
Yau-Huei Wei, PhD, National Yang-Ming University and Mackay Medical College
Shi-Bei Wu, PhD, National Yang-Ming University
March 13, 2013
Using a novel permeabilization reagent to uncover mechanisms of mitochondrial dysfunction
Anne Murphy, PhD, University of California
Ajit S. Divakaruni, PhD, University of California
George Rogers, PhD, Seahorse Bioscience
February 27, 2013
Regulation of cancer cell growth by metabolic substrates
Anne Diers, PhD, Medical College of Wisconsin
January 24, 2013
The Hitchhiker's Guide to XF Bioenergetic Assays
Bradford G. Hill, PhD, University of Louisville
August 15, 2012
Understanding the tumor microenvironment, and its effect on tumor metabolism, progression and therapy
Robert J Gillies, PhD, Moffitt Cancer Center
Jonathan Wojtkowiak, PhD, Moffitt Cancer Center
June 19, 2012
Screening Anti-Ischemic Drugs with a Gas-Flow Modified XF Analyzer
Paul S. Brookes, PhD, University of Rochester Medical Center
May 16, 2012
Programming the Mitochondrial Choice of Fuel Substrates: Metabolic Control of Neuronal Excitability
Nika Danial, PhD, Dana-Farber Cancer Institute
April 17, 2012
Assessing bioenergetic function in response to oxidative stress by metabolic profiling
Brian P. Dranka, PhD, Medical College of Wisconsin
March 27, 2012
Mitochondrial Respiratory Capacity Is a Critical Regulator of CD8+ T Cell Memory Development
Erika Pearce, PhD, Washington University School of Medicine
St. Louis, MO
February 14, 2012
Mitochondrial Bioenergetics in Diabetic Cardiomyopathy
E. Dale Abel MD PhD, University of Utah School of Medicine
December 14, 2011
Biochemical analysis in C. elegans as a model for metabolic disease and aging
Laurent Mouchiroud, PhD, École Polytechnique Fédérale de Lausanne
Riekelt H. Houtkooper, PhD, École Polytechnique Fédérale de Lausanne
November 30, 2011
Bioenergetic Evaluation in Mitochondrial Disorders
Massimo Zeviani, MD, PhD, The Foundation 'Carlo Besta' Institute of Neurology
Valeria Tiranti, PhD, The Foundation 'Carlo Besta' Institute of Neurology
September 27, 2011
XF Glycolysis Stress Test Assesses Glycolysis and Glycolytic Capacity in Cells
Min Wu, PhD, Seahorse Bioscience
August 30, 2011
Adaptation of Microplate-based Respirometry for Hippocampal Brain Slices
Brian Polster, PhD, University of Maryland Medical School
May 12, 2011
Multidimensional control of mitochondrial energy production: learning from physiology and pathology
Rodrigue Rossignol, PhD, Université de Bordeaux
April 27, 2011
Using Reserve Capacity to Screen for Mitochondrial Toxicities and Biogenesis
Craig C. Beeson, PhD, Medical University of South Carolina
March 23, 2011
New dimensions in adipocyte metabolism: Using the XF to probe human and rodent adipocytes and adipose tissue
Sheila Collins, PhD, Diabetes and Obesity Research Center, Sanford-Burnham Medical Research Institute
Einav Yehuda-Shnaidman PhD, RD, The Hebrew University of Jerusalem
February 9, 2011
Metabolic Reprogramming Therapy in the Treatment of Cancer
Nicholas Denko, MD, PhD, Stanford University, School of Medicine
October 27, 2010
Mitochondria Regulate Cancer
Navdeep S. Chandel, PhD, Northwestern Medical School
September 22, 2010
Profiling Mitochondrial Function has never been so Easy: A Tutorial on the New XF Mito Stress Test Kit
David Ferrick, PhD, CSO, Seahorse Bioscience
September 1, 2010
Mitochondrial Profiling in Cells Under Physiological Conditions and In Response to Stress
Victor Darley-Usmar, PhD, University of Alabama at Birmingham
August 4, 2010
Analysis of Glutaminolysis and Fumarate Respiration in Bcl-xL-expressing Cells
David M. Hockenbery, MD, Internal Medicine at the University of Washington
April 14, 2010
Importance of the Mitochondrial Reserve Capacity in Cardiovascular Cells Exposed to Oxidative Stress.
Brad Hill, PhD, Center for Diabetes and Obesity Research, University of Louisville
January 20, 2010
Assaying Isolated Mitochondria in the Seahorse XF24: Learning More while Requiring Less
Anne Murphy, PhD, University of California at San Diego
October 28, 2009
How to Measure Mitochondrial Function in Whole Islets. Sensing the nutrient sensor: measuring bioenergetic parameters from intact mouse and human islets of langerhans
Orian Shirihai, MD, PhD, Boston University Medical Center
July 16, 2009
The Rate and Coupling Efficiency of Oxidative Phosphorylation in Mitochondria and Cells
Martin Brand, PhD, Buck Institute, MRC Dunn Human Nutrition Unit
December 8, 2008
Tutorial 2: Measuring Bioenergetics in Primary Cell Types
David Ferrick, PhD, CSO, Seahorse Bioscience
August 27, 2008
Tutorial: Measuring Bioenergetics in a Variety of Cell Types
David Ferrick, PhD, CSO, Seahorse Bioscience
July 17, 2008
Human Disorders of Bioenergetics
Vamsi Mootha, MD, Harvard Medical School Center for Human Genetics, Massachusetts General Hospital
February 26, 2008
- Video Library
- Webinars
- Product Literature Database
- Seahorse XF Data
- Assay Templates
- Seahorse Cell Reference Database
- Seahorse Report Generators
Seahorse XFp Extracellular Flux Analyzer
The Fastest Way to a Metabolic Phenotype
Learn More
Seahorse XF Assay Kits
Seahorse XF Cell Energy Phenotype Test
Measure the metabolic phenotype and potential of your cells.
On Demand Webinar
Metabolomics: Redefining the Role of Fuels in Tumorigenesis
Julie Saint-Pierre, Ph.D.
Ajit Divakaruni, Ph.D
May 24, 2016


text:
For today' chart we've chosen to take a look at Columbus McKinnon Corp (Nasdaq:CMCO) because it has been trading within a horizontal channel pattern. As you can see from the chart below, this stock has been range-bound between $21 and $25.50 for the past six months and recent price action is suggesting this story will continue. The sideways price action is viewed by traders as a time of indecision and we would expect this sideways trend to continue until we see a break beyond one of the mentioned barriers. Traders are always interested in channel patterns because a move beyond the upper or lower part of the channel is generally followed by a sharp movement in the direction of the breakout.
We've also added the MACD indicator, which has recently crossed below its signal line. This bearish crossover will be used by traders to confirm the strength of the nearby resistance and many range-bound traders will watch for a move toward the $21 support.


text:
Justin Timberlake And Jay-Z May Suit Up On Tour Together
By Jessica Rawden 3 years ago
Jay-Z and Justin Timberlake recently teamed up for Timberlakes single Suit & Tie, and now the two men may be taking the show on the road. If you watched this years Grammy Awards, youve gotten a taste of what the two men will present if and when they tour together.
Yes, you read that correctly. On Tuesday, the NY Post broke the news that the famed rapper and producer and the talented actor and singer are set to produce a road show together. Timberlake first hinted at such magnificent news two days ago via Twitter.
Big news coming out after Justins #Grammys performance. Stay tuned or youll miss it!
Timberlake hasnt officially confirmed the news yet, nor has Jay-Z, but after the Grammys, the 32-year-old singer did state on the red carpet, Were definitely going to go on tour. Considering Timberlake and wife Jessica Biel sat next to Jay-Z and wife Beyoncé during the ceremony, this adds evidence to the fact that his touring partner will be the rapper and new father. Plus, now that Timberlake has put out a second single, Mirrors, hes likely itching to hit the road, and deciding to tour with Jay-Z would definitely add a higher ticket price tag to the whole endeavor. I know Im not alone when I say I would pay a pretty high number to see the two men take the stage in one night.
Well let you know when new details about the potential tour emerge, but either way, we can definitely tell you that if it happens, it will be a well-dressed endeavor.


text:
Prep Time: 10 Min
Cook Time: 0 Min
Servings: About 1 1/2 quarts
Serving Size (1/2 cup, 1/12 of recipe), Calories 220 (Calories from Fat 110), Total Fat 12g (Saturated Fat 7g, Trans Fat 0g), Cholesterol 40mg, Sodium 65mg, Total Carbohydrate 23g (Dietary Fiber 0g, Sugars 20g), Protein 5g; Percent Daily Value*: Vitamin A 8%, Vitamin C 2%, Calcium 15%, Iron 0%.
*Percent Daily Values are based on a 2,000 calorie diet.
Are you sure you want to delete this recipe?
Recipe has been added to your Recipe Box.


text:
Alice In Chains has released two new music videos at the same time from the band's latest album, The Devil Put Dinosaurs Here. The first is for the song "Voices," while the second is for the epic title track. Guitarist Jerry Cantrell told us how he feels about the subject matter of the latter song: "When your belief says it's okay to strap a bomb on your body and blow somebody else up, or beat somebody up because they're gay, or try to pass some laws and legislate what a woman can do or can't do with her own body, when it comes to teaching prejudice, ignorance, the denial of just fact . . . some of the uglier things that are done in the name of religion to each other are pretty horrible, and that's what that song is about."
- "Voices" is the third single released from the new album after the chart-topping "Hollow" and "Stone."
- The Devil Put Dinosaurs Here debuted at Number Two on the Billboard album chart in June, selling 61,000 copies in its first week of release.
- Alice In Chains is co-headlining the fourth annual Rockstar Energy Uproar Festival with Jane's Addiction. The trek stops in Ridgefield, Washington on Sunday (September 8th).