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The investigation of fire incidents in buildings is essential in understanding the consequences on occupants and property. Moreover, a fundamental role in life safety and property protection is represented by the minutes after the fire ignition. Therefore, it is possible to evaluate the effects that the discovery time of occupants and response time of the fire brigades have on a successful evacuation, reduction of fatalities and fire confinement in buildings. The Dwellings and Other buildings fire statistical databases published by the Home Office in England with data from 2010/11 to 2016/17 are investigated to determine how the fatality/casualty rates vary with different discovery times in Dwellings according to the methodology provided by Ramachandran, and adopted in the PD 7974-7:2003. Furthermore, the average response time of the fire brigades for Dwellings and Other buildings appears to be between 7-8 and 8-9 minutes, respectively. When the response times are analyzed in terms of the fatality/casualty rate, there is an upward trend in Other buildings. Finally, response time is also examined considering fire spread, fire and total damage showing that in Other buildings the classes of more severe fire damage increase for a response time between 6 and 8 minutes.

Autonomous vehicles (AVs) and cooperative automated vehicles (CAVs) are expected to largely reshape our mobility systems. The limited deployment of AVs and CAVs on roads makes it difficult to fully assess their impact and interactions with other road users. Advanced simulations are often sought for conducting accelerated tests of AVs and CAVs in a virtual environment. However, existing off-the-shelf simulators are typically focused on conventional traffic simulation and human-driving simulation. Advanced simulators that enable core functionalities (e.g., sensing and communication) of AVs and CAVs have been underexploited. In this paper, the authors aim to develop a realistic co-simulation framework for testing autonomous driving and cooperative driving automation (CDA). The proposed co-simulation framework utilizes the open-source concept to support the AV and CAV community in developing and deploying AV and CAV technologies. This framework integrates multiple open-source platforms, including Eclipse MOSAIC™ simulation framework, Eclipse Simulation of Urban Mobility (SUMO™) traffic simulator, and CARLA AV driving simulator. The framework enables AV and CAV simulation in mixed traffic environments. The developed co-simulation models have been tested with different scales of networks and traffic flow. The assessment of the co-simulation framework shows that it can support faster-than-real-time simulation for use in accelerated tests with more realistic scenarios. In addition, the developed co-simulation framework is proven to be extensible with the inclusion of other network simulators for supporting vehicle-to-everything (V2X) communication among vehicles.

In many assessment problems—aptitude testing, hiring decisions, appraisals of the risk of recidivism, evaluation of the credibility of testimonial sources, and so on—the fair treatment of different groups of individuals is an important goal. But individuals can be legitimately grouped in many different ways. Using a framework and fairness constraints explored in research on algorithmic fairness, I show that eliminating certain forms of bias across groups for one way of classifying individuals can make it impossible to eliminate such bias across groups for another way of dividing people up. And this point generalizes if we require merely that assessments be approximately bias-free. Moreover, even if the fairness constraints are satisfied for some given partitions of the population, the constraints can fail for the coarsest common refinement, that is, the partition generated by taking intersections of the elements of these coarser partitions. This shows that these prominent fairness constraints admit the possibility of forms of intersectional bias.

Objective To describe current approaches in treatment of opioid use disorder (OUD) within Canadian psychosocial outpatient, day, and residential addiction treatment programs, with an emphasis on the use of opioid agonist therapy (OAT). Method An online census survey was conducted in English and French of Canadian psychosocial addiction treatment programs ( N = 214). Results Programs estimated that 25% of their clients have OUD. A slight majority of programs provide some type of specialized services to clients with OUD (58%), most frequently providing or facilitating access to OAT but also specialized counselling, case management, education, and harm reduction services. Most programs reported that they admitted clients on OAT (88%) and only a minority expected or encouraged clients to taper (14%) or discontinue (6%). Programs focusing on client abstinence as the treatment goal were more likely to expect or encourage tapering or discontinuation than programs that focus on helping clients achieve personal consumption goals. Of programs that did not currently facilitate OAT, 44% indicated that they would provide OAT, but lacked the necessary accreditation, physician support, or other resources. No philosophical objections to OAT were noted. OAT initiation was provided by 30% of programs, 23% referred to another service within their organization, and 29% referred to a service outside their organization. The remaining 18% did not facilitate OAT initiation at all, ranging from 0% in Quebec to 23% in the Prairies. Overdose response kits were provided by 86% of programs. The majority not providing kits indicated willingness if policy support and resources were provided (67%). Conclusions Overall, the results demonstrate that psychosocial programs provide some specialized services for OUD but desire further support specifically to provide OAT, including training, knowledge, and the expertise of individuals qualified to prescribe and dispense OAT. Many psychosocial treatment programs expressed a need for staff and resources for this purpose.

The term resilience is being more widely adopted in fire safety engineering, however, its comprehensive description is not clearly explained or correctly applied in practice. This study, therefore, defines the categories, dimensions, characteristics, capacities, objectives and missions possessed by resilience to provide a holistic understanding of the term. This is followed by an analysis and classification of the UK Standards and Codes addressing resilience considering their administrative and engineering features of resilience, and their resilience dimensions with definitions of fire resilience measures and approaches. A practical example of a fire resilience framework is applied in educational buildings considering internal resilience for a safe facility, risk reduction and disaster management, and external resilience involving redundancy of resources and community support. Finally, a fire resilience design framework is created in which structural and fire safety engineering are considered clarifying the steps to follow in a comprehensive design process based on a flow chart. This paper will contribute to the creation of a unified terminology and understanding of the concept linked to resilience to be adopted in various disciplines.

Conspiracy theories are not new to religion, nor an exclusively modern phenomenon. But they take on more destructive and wide-ranging impact with modern communication technologies. Looking at the root psychosocial mechanisms of conspiracy theories, we argue that they frame ideas, history, and culture through the cognitive mindscape of special, ‘hidden knowledge’. They also serve as a unifying theory of conflict and narration of history. The COVID epidemic has strained the economic and political system. Although it may be a matter of perception for Q-followers, a sense of precarity is enhanced by QAnon, thus unleashing and mustering an awakening for such extremist paranoid discourse of ressentiment. This parallels the cognitive mindscape of ‘the Great Replacement’. Prior to election 2020, QAnon’s base had been growing in Evangelical communities. Its presence continues to be felt.

First responders encounter many hazards in the execution of their duties, and exposure to hazardous materials such as opioids is a primary safety concern. The ongoing opioid crisis in the United States continues to be a major public health issue, with overdose deaths from opioids reaching epidemic levels. Although responders frequently encounter opioids, available data on safety and risk are not always well-communicated, and we identified a need for refresher and just-in-time training products on this topic. In response, we created a training video series that is informative, concise, and visually appealing. The video series, available on YouTube, was tested with a small initial population, with findings suggesting key questions for a larger study focused on integration of the refresher training with existing programs to optimize retention and adoption of safety practices.

This study investigates inpatient surgical outcomes for people experiencing homelessness (PEH) in Australia. Retrospective administrative health data of emergency surgical admissions from a single center over 5 years, 2015 to 2020, was included. Independent associations between factors and outcomes were analyzed with binary logistic and log-linear regression. Of 11 229 admissions, 2% were experiencing homelessness. People experiencing homelessness were on average younger (49 vs 56 years), more likely to be male (77% vs 61%), suffer mental illness (10% vs 2%), and substance use disorders (54% vs 10%). People experiencing homelessness were not more likely to suffer surgical complications. However, male sex, older age, mental illness, and substance use were risk factors for poor surgical outcomes. Homelessness predicted greater odds of discharge against medical advice (4.3 times) and longer length of stay (1.25 times). These results highlight the need for health interventions simultaneously addressing physical, mental health, and substance use issues in the care of PEH.

Atrial fibrillation (AF) is the most common arrhythmia in the world. Despite the increasing prevalence, there remains a limited understanding of how the pre-diagnosis symptom experience varies by gender. The purpose of this study was to retrospectively explore gender differences/similarities in the pre-diagnosis period of AF. Twenty-six adults (13 men and 13 women) were interviewed guided by the Symptom Experience in AF (SEAF). Data were analyzed using a two-step approach to thematic analysis. Women had greater challenges receiving a timely diagnosis, with 10 women (77%) experiencing symptoms ≥1 year prior to their diagnosis, in comparison to only three (23%) of the men. Women also reported more severe symptoms, less AF-related knowledge, viewed themselves as low risk for cardiovascular disease, and described how their comorbid conditions confused AF symptom evaluation. This study provides a foundational understanding of differences/similarities in the AF symptom experience by gender.

Background Patients with a history of opioid use disorder (OUD) tend to have more complications, higher readmission rates, and increased costs following orthopaedic procedures. This study evaluated patients undergoing hallux valgus correction for their odds of increased (1) readmission rates, (2) emergency room (ER) visits, and (3) costs. Methods Patients undergoing hallux valgus corrections with OUD history were identified using a national Medicare administrative claims database of approximately 24 million orthopaedic surgery patients. OUD patients were matched to non–opioid use disorder (NUD) patients in a 1:4 ratio by age, sex, Elixhauser-Comorbidity Index (ECI), diabetes mellitus, hyperlipidemia, hypertension, and tobacco use. The query yielded 6318 patients (OUD = 1276; NUD = 5042) who underwent a hallux valgus correction. Primary outcomes analyzed included odds of 90-day readmission rates, 30-day ER visits, and 90-day episode-of-care costs. Demographics, odds ratios (ORs), ECI, and cost were assessed as appropriate using a Pearson χ2 test, logistic regression, and a t test. A P value Results There were no significant differences in demographics between OUD and NUD patients. OUD patients had higher incidence and odds of 90-day readmission (9.56% vs 6.04%; OR = 1.55; P < .001) and 30-day ER visits (0.86% vs 0.35%; OR = 2.42; P = .021) and incurred greater 90-day episode-of-care costs ($7208.28 vs $6134.75; P < .001) compared with NUD patient controls. Conclusion The study demonstrates the possible influence of OUD on higher odds of readmission, ER visits, and costs following a hallux valgus correction. Levels of Evidence Level III: Retrospective cohort study

Introduction. The sensitivity and specificity for magnetic resonance imaging (MRI) diagnosis of osteomyelitis is 90% and 80%, respectively; findings include bone marrow edema, T2-weighted image hyperintensity (HI-T2WI), T1-weighted image confluent signal(CS-T1WI), and cortical erosion (CE). The goal is to determine which risk factors and MRI findings are most predictive of osteomyelitis. Materials and Methods. After institutional review board approval, records of patients who underwent bone biopsy of the foot/ankle between 2015 and 2017 were reviewed. Diagnosis was determined histologically. Blinded MRI review identified indicators of osteomyelitis: HI-T2WI, CS-T1WI, ulcer depth, and CE. Bivariate and multivariate regression determined an association between osteomyelitis and radiographic indicators. Results. Of 59 subjects, 41 (69.5%) and 18 (30.5%) had pathologic evidence of osteomyelitis or were indeterminate. The sensitivity and specificity by radiologist diagnosis was 51.4% and 91.7%, respectively. Diabetes (relative risk [RR]=2.9, 95% CI = 1.0.8-7.77, P = .034), CS-T1WI (RR = 1.6, 95% CI = 1.23-2.20, P < .001), and CE (RR = 1.8, 95% CI = 1.34-2.28, P < .001) were risk factors on bivariate analysis. Ulcer depth demonstrated a trend toward statistical significance. Diabetes (RR = 2.4, 95% CI = 1.00-5.69, P = .049) and CE (RR = 1.7, 95% CI = 1.27-2.37, P < .001) were independent risk factors on multivariate analysis. Discussion. Diabetes and CS-T1WI are independent risk factors for pedal osteomyelitis. Patients with diabetes, CS-T1WI, and CE should be evaluated for osteomyelitis with recommendation for bone biopsy in appropriate clinical settings. Levels of Evidence: Level III Retrospective Comparative Study

Objectives There are ongoing investigations into diet-associated dilated cardiomyopathy in dogs, but there has been minimal investigation into possible diet-associated dilated cardiomyopathy in cats. The objective of this study was to compare cardiac size and function, cardiac biomarkers and taurine concentrations in healthy cats eating high- vs low-pulse diets. We hypothesized that cats eating high-pulse diets would have larger hearts, lower systolic function and higher biomarker concentrations than cats eating low-pulse diets and that there would be no difference in taurine concentrations between the diet groups. Methods Echocardiographic measurements, cardiac biomarkers, and plasma and whole-blood taurine concentrations were compared between cats eating high- and low-pulse commercial dry diets in a cross-sectional study. Results There were no differences between the high- (n = 21) and low-pulse (n = 31) diet groups with regard to age, sex and breed, but more cats in the high-pulse group were overweight or obese (67% vs 39%; P = 0.05). Diet duration was not different in the groups, but the range was wide (6–120 months). No differences were found between the diet groups for key cardiac measurements, biomarker concentrations, or plasma or whole-blood taurine concentrations. However, there were significant negative correlations between diet duration and measures of left ventricular wall thickness in the high-pulse, but not the low-pulse, diet group. Conclusions and relevance This study did not detect significant associations between high-pulse diets and cardiac size, function and biomarkers, but the secondary observation of significant negative correlations between time on high-pulse diets and left ventricular wall thickness warrants further evaluation.

The Code of Professional Ethics for Rehabilitation Counselors (CRCs) directs CRCs to “. . . apply appropriate decision-making models and skills to resolve dilemmas and act ethically” (Section M—Introduction). Other codes of ethics include similar verbiage, suggesting knowledge and application of the Code as a beginning step when using an ethical decision-making model. The updated “Resolving Ethical Dilemmas” section of the Code (now Section M) guides CRCs on using the Code as a tool when encountering ethical dilemmas. This article describes updates to Section M resulting from the Code revision process. Contemporary counseling ethical decision-making models are reviewed, and descriptions of Commission on Rehabilitation Counselor Certification (CRCC) resources to assist with ethical decision-making are provided. In addition, an examination of the CRCC ethics committee’s process for addressing grievances and providing advisory opinions is outlined. In addition, this article provides a brief overview of how the committee relies on the Code overall, specifically Section M, to carry out its mission. Two case studies provide examples using the Code to examine a process for resolving ethical dilemmas.

Using qualitative methods, we examine telehealth care quality from the perspective of parents of pediatric patients during a pandemic. We fill a gap in the literature essential for measuring effectiveness of pediatric telehealth. A total of 22 participants (n = 21 female; n = 1 male) enrolled in 1 of 9 interviews and focus groups conducted in 2021. Transcribed data were thematically analyzed and organized based on the 6 domains of quality health care by the Institute of Medicine (IOM). Analyzed data revealed 7 themes and 52 codes. Pediatric telehealth visits were perceived as efficient, timely, safe, and generally effective by parents for their child’s health care. Participants experienced equal or greater time with their child’s care provider via telehealth than through in-person visits. Qualitative results directly align with IOM domains of quality health care and contribute to the growing literature and evidence that may lead to improved telehealth outcomes and better preparedness for emergent public health events.

In this article, I explore sensemaking processes associated with the overview effect—a cognitive shift experienced by astronauts who see Earth from space. Analysis of publicly available interviews ( n = 51) with astronauts revealed a common sequence of sensemaking: First, astronauts reported experiencing speechlessness triggered by beauty and awe (a phenomenon I label, awe-mute). Second, during and after missions, most reported attempting to make sense of the experience with others, often resulting in a deepening of their previously-existing worldviews, a process I term sensedeepening. Third, sensedeepening often resulted in astronauts’ (a) admissions of inadequacy to give sense to their experience for others, and despite this, (b) development of messages to communicate their experiences, and (c) engagement in social activism. These patterns were corroborated by additional interviews with astronauts ( n = 5) and an interview with a prolific interviewer of astronauts. Implications for sensemaking theory and organizational change conclude the article.

Previous studies have found that minority athletes were perceived more positively than their White counterparts, which is counterintuitive to previous research. In order to explain this “racial contradiction,” this study analyzes how an athlete's response strategy and the amount of sports news consumed by participants could impact differences in the perceptions of athletes of different races. A between-subjects, double-blind experiment was conducted among 464 participants to examine how an athlete’s race, an athlete’s chosen response strategy, and participants’ level of sports news consumption affect the perception of athletes accused of criminal allegations. Results show that while low sports news consumers did not differ in their perception of an athlete regarding whether he was Black or White, high sports news consumers perceived Black athletes more positively than White athletes, supporting the “racial contradiction.” Also, results showed that while participants who were low sports news consumers accepted the White athlete’s use of denial more than that of the Black athlete, participants who were high sports news consumers accepted the Black athlete’s use of denial more than that of the White athlete.

Objective:There is limited information to guide health-care service providers and policy makers on the burden of mental disorders and addictions across the Canadian provinces. This study compares interprovincial prevalence of major depressive disorder (MDD), bipolar disorder, generalized anxiety disorder (GAD), alcohol use disorder, substance use disorders, and suicidality.Method:Data were extracted from the 2012 Canadian Community Health Survey—Mental Health ( n = 25,113), a representative sample of Canadians over the age of 15 years across all provinces. Cross tabulations and logistic regression were used to determine the prevalence and odds of the above disorders for each province. Adjustments for provincial sociodemographic factors were performed.Results:The past-year prevalence of all measured mental disorders and suicidality, excluding GAD, demonstrated significant interprovincial differences. Manitoba exhibited the highest prevalence of any mental disorder (13.6%), reflecting high prevalence of MDD and alcohol use disorder compared to the other provinces (7.0% and 3.8%, respectively). Nova Scotia exhibited the highest prevalence of substance use disorders (2.9%). Quebec and Prince Edward Island exhibited the lowest prevalence of any mental disorder (8.5% and 7.7%, respectively). Manitoba also exhibited the highest prevalence of suicidal ideation (5.1%); however, British Columbia and Ontario exhibited the highest prevalence of suicidal planning (1.4% and 1.3%, respectively), and Ontario alone exhibited the highest prevalence of suicide attempts (0.7%).Conclusions:Significant interprovincial differences were found in the past-year prevalence of mental disorders and suicidality in Canada. More research is necessary to explore these differences and how they impact the need for mental health services.

This article recounts a day-trip to the Chernobyl Exclusion Zone and the ruined town of Pripyat through a series of ethnographic vignettes from the point of view of a tour guide. This article offers an approach that begins with questions of embodiment, materiality and agency in order to research worldly forces, such as radiation, without reducing them to only matters of language and thought. In responding to these challenges of the radioactive landscape of the Chernobyl Zone and Pripyat, the article offers ‘exposure’ as a model of subjectification, applicable beyond radioactive landscapes, which is based upon passivity, vulnerability and a foundational relation-with worldly others which exceed our perceptual, representational and bodily capacities. I introduce the work of Merleau-Ponty as a key theorist behind landscape geographies. In particular, the rejection of dualism and distance is shown to be a vital starting point when understanding tourism and guiding in the radioactive landscape of the Zone. Through the crackling and chirruping of the Geiger counter, the halting, careful movements of visitors and my own uncertainties, I illustrate how radiation is first encountered as a bodily exposure; which is only ever apprehended after-the-fact and experienced as vulnerability. I argue that a more passive, vulnerable sense of embodiment is needed than phenomenology provides, for which I bring the work of Irigaray into conversation with recent post-phenomenological work in geography.