The Rhetorical Art of Risk Assessment: Lessons from Risk Management in Rural and Tribal Communities

Risk assessment, mitigation, and communication rely on data from multiple sources to form a complete understanding of hazards and how to manage them. Experts can use these data to make informed decisions about the nature and extent of risks and inform the public to protect health, the environment, and economic welfare. However, in an effort to objectively make decisions, technical experts and policymakers increasingly rely on quantitative data as the most important determiner of risk, which can alienate the public, limit risk understanding, and delay or miss obvious signals of impending catastrophe. I examine several cases based on my experiences practicing and researching traffic safety, public safety, and technical and professional communication (TPC). The cases include a look at the impact of limited quantitative data in addressing motor vehicle traffic injuries and death in American Indian and rural communities; the challenge of collecting accurate data by first responders and firefighters to better understand and respond to health and physical hazards; and a recent history of failures to prevent airline and aerospace disasters due to an overemphasis on quantifiable data and devaluation of certain kinds of expert knowledge. The results of this study call attention to the weaknesses resulting from a quantitative imperative in risk management and a proposal for renewed focus on risk assessment using rhetorical practices and qualitative data readily available from expert and non-expert perspectives

Diet Prasejarah Masyarakat Pada Zaman Akhir Pleistosen Akhir Hingga Holosen Di Sarawak Dan Sabah Dari Perspektif Arkeozoologi

Penyelidikan ini memfokuskan kepada sisa fauna vertebrata dari lapisan kebudayaan akhir Pleistosen Akhir hingga Holosen iaitu merangkumi sampel berusia 32,600±210 BP hingga 2,000 BP di Sarawak dan Sabah. Sampel arkeozoologi yang dianalisis adalah dari hasil ekskavasi terbaru (Gua Kain Hitam B, Bukit Tengkorak, Bukit Kamiri dan Melanta Tutup) dan ekskavasi terdahulu (Lobang Angus, Gua Sireh, Agop Atas, Agop Sarapad, Hagop Bilo dan Pulau Balambangan) dari tapak di Sarawak dan Sabah. Tujuan kajian ialah untuk menyelesaikan isu, masalah dan persoalan-persoalan yang mencakupi a) spesies fauna vertebrata dan diet prasejarah, b) aktiviti subsisten dan adaptasi, c) strategi dan amalan memburu dan d) modifikasi sisa fauna. Metod yang diaplikasi melibatkan kerja lapangan (persampelan, konservasi dan analisis lapangan), analisis makmal (konservasi, anatomi, taksonomi dan tafonomi) dan analisis statistik (TNF, NISP dan MNI). Data-data tersebut digabungkan untuk membentuk interpretasi mengenai diet prasejarah dari perspektif arkeozoologi. Hasil analisis anatomi dan taksonomi menunjukkan pelbagai spesies haiwan dikenalpasti wujud dan telah dieksploitasi sebagai sumber diet pada zaman akhir Pleistosen Akhir hingga Holosen. Contohnya, primat (Orang-Utan Pongo pygmaeus), roden (landak Hystrix brachyura), karnivor (musang Paradoxurus sp.), Pholidota (tenggiling Manis javanica), Perissodactyla (badak Rhinoceros sondaicus), Artiodactyla (rusa Cervus sp.), unggas (ayam hutan Gallus sp. dan helang Spizeatus sp.), reptilia (Geoemydidae, Trionychidae dan Cheloniidae) dan ikan air tawar serta ikan marin

COVID-19 in children: Intensive care management

Aralık 2019'da Çin'in Wuhan eyaletinde yeni bir tip koronavirüs enfeksiyonu ortaya çıktı ve hızla yayılmaya başladı. Hastalığa neden olan virüs şiddetli akut solunum yolu sendromu coronavirüs-2 (SARS-CoV-2) olarak bildirilmiştir. O zamandan beri virüs dünya çapında 200'den fazla ülkeyi etkiledi ve küresel bir salgına neden oldu. Günümüzde, COVID19 pandemisi tüm dünyayı etkisi altına almaya devam ediyor. COVID-19 hastalığı çocuklarda yetişkinlere göre daha hafif veya asemptomatik seyretmekle beraber zaman ilerledikçe, COVID-19’ a bağlı kritik hasta çocuk sayısında artış görülmeye başlanmıştır. Biz bu derlemede kritik COVID-19 çocuk hastalarının takip ve tedavisini güncel kılavuzlar ışığında sunmayı planladık.In December 2019, a novel type of coronavirus infection emerged in the Wuhan province of China and began to spread rapidly. The disease is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Since then, the virus has affected more than 200 countries worldwide and caused a global pandemic. COVID-19 pandemic continues to have a growing impact on the whole world. Although COVID-19 disease have milder or asymptomatic course in children compared to adults, as time progresses, the number of critically ill children due to COVID-19 has begun to increase. In this review, we planned to present the followup and treatment of critical COVID-19 pediatric patients in the light of current guidelines

Residents and interns in the 3 university hospitals: their knowledge of and attitudes to drug allergy

Background: Previous studies revealed there are many gaps in the awareness and knowledge regarding the diagnosis and management of drug allergy (DA) among various health-care professionals. Objective: To assess the knowledge, attitudes, and practices towards DA among residents and interns of 3 university hospitals in the region of Trakya (Thrace), Turkey. Methods: A cross-sectional survey was conducted at university hospitals of 3 cities in the Trakya region: 1. Trakya University Medical Faculty, Edirne (n = 405), 2. Namik Kemal University Medical Faculty, Tekirdag (n = 114), and 3. Canakkale 18 Mart University Medical Faculty, Canakkale (n = 111). A Turkish questionnaire was developed based on previous published studies. Results: The majority of participants (67%) had not received education on DA as a separate subject during their medical education. Less than a third (28.3%) of all respondents were satisfied with their knowledge concerning patients with clinical signs of DA. Of the 6 knowledge questions on DA, the average score for the study was 3.51 out of 6 (58.5%). Residents had a higher knowledge score (3.93 +/- 1.1) compared with interns (3.05 +/- 1.2) (p < 0.001). The lowest percentage of correct answers were in response to questions on laboratory confirmation of drug-related anaphylaxis (14.5%) and the possibility of penicillin toleration in patients with a history of penicillin allergy (11.8%). The majority of participants (92%) believe that medical doctors should be educated in DA. There were no significant correlations between taking DA histories and the frequency during daily practice of encountering patients. Conclusion: Our study revealed that DA knowledge and attitudes are not at satisfactory level among respondents, and we concluded the importance and necessity of reinforcement of DA education in pre- and postgraduate education of medical doctors

Community Engagement in a Graduate-Level Community Literacy Course

A case study of a graduate-level community literacy seminar that involved a tutoring project with adult digital literacy learners, this essay illustrates the value of community outreach and service-learning for graduate students in writing studies. Presenting multiple perspectives through critical reflection, student authors describe how their experiences contextualized, enhanced, and complicated their theoretical knowledge of public rhetoric and community literacy. Inspired by her students’ reflections, the faculty co-author issues a call to graduate programs in writing, rhetoric, literacy studies, and technical communication to develop a conscious commitment to graduate students’ civic engagement by supporting opportunities to learn, teach, and research with community partners

Hypogammaglobulinemia Prevelance in Children with Atopic Dermatitis and the Relationship Between Immunoglobulin Levels and Eczema Severity

Aim:Atopic dermatitis (AD) is the most common chronic skin disease of childhood. Although eczema may be a prominent finding in some primary immune deficiencies, there are very few studies conducted on the frequency of hypogammaglobulinemia in patients with eczema. In our study, we aimed to determine the frequency of hypogammaglobulinemia in patients with AD and the relationship between immunoglobulin levels and eczema severity.Materials and Methods:Patients between the ages of 0-18 years, who were diagnosed with AD between January 2015 and August 2018 in the Department Pediatrics Division of Pediatric Allergy and Immunology, Trakya University Faculty of Medicine, were included in the study. Hypogammaglobulinemia was defined as being less than -2 standard deviation of immunoglobulin A, M and G from normal values for age.Results:The median age of 117 patients included in the study was 11 months [interquartile range (IQR): 6.7-33 months], the median age of eczema onset was 3.5 months (IQR: 2-6 months), the median SCORingAtopicDermatitis at presentation was 13.8 (IQR): 5-32]. Thirty-six (30.8%) patients had low levels in one of the immunoglobulin isotypes and decreased levels of immunoglobulin A (IgA), M and G were found in 21 (17.9%), 18 (15.5%) and 23 (19.7%) patients, respectively. While there was no difference between mild and moderate-severe eczema groups in terms of age at presentation, age of onset of eczema, family history of allergic diseases, smoking exposure, aeroallergen sensitivity, food allergy, the number of patients having hypogammaglobulinemia, and the levels of IgA, M and G, a male predominance and higher number of eosinophils were observed in the moderate-severe eczema group.Conclusion:It is concluded that the evaluation of immunoglobulin levels independent of the severity of eczema is important for the distinction of primary immunodeficiency and the follow-up of patients in terms of transient hypogammaglobulinemia of infancy in patients with AD

Common MEFV gene mutations in children with FMF in Diyarbakır, Turkey

Ailevi Akdeniz Ateşi otozomal resesif bir hastalık olup, periyodik karın ağrısı, ateş ve eklem ağrısı ile karakterizedir. Ailevi Akdeniz Ateşinden sorumlu tutulan MEFV geninde bir çok mutasyon belirlenmiştir. Bu çalışmamızda klinik olarak Ailevi Akdeniz Ateşi şüphesi taşıyan toplam 332 çocuktan DNA örnekleri alındı ve 12 MEFV mutasyonu [E148Q, P369S, F479L, M680I (G/C), M680I (G/A), I692del, M694V, M694I, K695R, V726A, A744S, R761H] ters hibridizasyon yöntemi ile yapıldı. Toplam 113 çocukta (ortalama yaş: 11.5 yıl) mutasyon tespit edildi. E148Q mutasyonu 60 çocukta (4 tanesi homozigot), M694V mutasyonu (4 tanesi homozigot) 19 çocukta, P369S mutasyonu (homozigot mutasyon yoktu) 16 hastada ve V726A mutasyonu (homozigot mutasyon yoktu) 13 çocukta tespit edildi. Ancak Ailevi Akdeniz Ateşi şüphesi ile mutasyon analizi istenen 332 çocuktan toplam olarak 104’ünde tanı kriterlerine göre hastalığın tanısı klinik olarak doğrulandı. Ailevi Akdeniz Ateşi tanısı alan hastalarda gen mutasyonları sıklık sırasına göre; E148Q (%30.8), M694V (%18.3), P369S (%10.6), V726A (%8.6), A744S (%2.9), R761H (%2.9), M694I (%1.9), K695R (%1.9) ve I692del (%1.0). Ailevi Akdeniz Ateşi tanısı konan hastaların 15’inde (%14.4) hiçbir mutasyon saptanmazken, 13’ünde (%12.5) iki farklı mutasyon aynı anda belirlenerek bileşik heterezigot olarak tanımlandı. Sonuç olarak hastalarımızda E148Q mutasyonuna, normalde en sık görülen M694V mutasyonundan daha sık rastlandı. Bu farklılık demografi k yapı veya metot ile ilişkili olabilir.Familial Mediterranean Fever (FMF) is an autosomal recessive disease that clinically characterized by periodic abdominal pain, fever and arthralgia. Wide variety of mutations have been described in MEFV gene which is known to be responsible from FMF. In present study, 12 MEFV mutations [E148Q, P369S, F479L, M680I (G/C), M680I (G/A), I692del, M694V, M694I, K695R, V726A, A744S, R761H] have been screened. DNA samples were obtained from a total of 332 children, who were clinically suspected as FMF. Mutation analyses of MEFV gene were carried out with reverse hybridization method. In 113 children (mean age 11.5 years), mutations have been detected. In 60 children E148Q (4 homozygous), in 19 M694V (4 homozygous), in 16 P369S (none), and in 13 children V726A (none homozygous) mutations were detected. Among Familial Mediterranean Fever -suspected 332 children 104 fulfi lled diagnostic criteria for FMF and detected MEFV gene mutations with decreasing frequency were; E148Q (30.8%), M694V (18.3%), P369S (10.6%), V726A (8.6%), A744S (2.9%), R761H (2.9%), M694I (1.9%), K695R (1.9%) and I692del (1.0%), respectively. No mutation was detected in 15 (14.4%) FMF children while, two different MEFV mutations were detected together in 13 (12.5%) patients and these patients were accepted as a compound heterozygous. In conclusion, in our patients E148Q mutation was found higher than M694V mutation that has been detected commonly in patients with FMF. The difference may result from demographic features or used methods