ANCHORAGE, Alaska?? Scientists were watching a remote Alaska volcano on Friday, a day after it belched out an ash cloud that quickly dissipated, and officials said airline flights over the region had not been disrupted.
Ash from the 5,676-foot volcano is considered potentially dangerous to aircraft because Cleveland's peak lies directly below commercial flight paths between Asia and North America. Another ash-producing explosion could come without warning.
Thursday's explosion at the Cleveland Volcano in the Aleutian Islands sent a plume 15,000 feet into the air, but it dissipated within hours, said Cheryl Searcy, a geophysicist with the Alaska Volcano Observatory.
"It was a pretty small little burp out of it," Searcy said. "As of now, we have not had any more of those."
The volcano, located 940 miles southwest of Anchorage in a remote area where scientists lack on-site monitoring instruments, sent ash clouds as high as 39,000 feet in 2001.
"So it is possible that it really can put a major plume" into the atmosphere, Searcy said.
Federal Aviation Administration spokesman Mike Fergus said all airlines with operations in the U.S. northwest were notified of the eruption, but he was not aware of any planes being diverted or deviating from flight plans as a result.
He noted that commercial airplanes typically fly above 15,000 feet, the level of the ash plume. Officials from United Airlines, Delta Air Lines and Alaska Airlines said there were no disruptions to their flights.
Cleveland, on the uninhabited Chuginadak Island, is one of Alaska's 90 active volcanoes and has been in an eruptive phase since July, when lava started oozing out of the crater and forming a hardened dome. Scientists keep tabs on the mountain with satellite data, eyewitness reports and video from mariners and pilots.
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Thursday's explosion, captured by satellite imagery, likely stemmed from a gradual buildup of pressure during months of intermittent low-level eruptions, another geophysicist with the Alaska Volcano Observatory, Dave Schneider, has said.
Interference with air travel is the most immediate risk posed by Alaskan volcanoes, as jet engines are vulnerable to damage and sudden failure if they suck in gritty volcanic dust.
A KLM airliner abruptly dropped more than 14,000 feet when it flew through ash belched into the atmosphere from an eruption of the Mount Redoubt volcano, just west of Cook Inlet, in 1989. The badly damaged jet landed in Anchorage.
Elsewhere, an ash cloud from a Chilean volcano grounded flights across eastern and southern Australia in June. The eruption of an Icelandic volcano in 2010 led to 100,000 canceled flights, hampering the air travel of some 10 million people.
Copyright 2011 Thomson Reuters. Click for restrictions.
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MIRA LOMA, Calif. -- Authorities say a 12-year-old girl was struck and killed on a Southern California freeway as she ran through traffic while attempting to retrieve clothing from the roadway.
The patrol says suitcases had fallen from the roof rack of the car that Flores was traveling in, scattering the clothes.
John Sullivan was driving about 70 mph when he saw the girl, but it was too late to avoid the collision. The 74-year-old wasn't injured or arrested.
Heard about the untethered jailbreak for the original iPad, iPhone 4, iPod touch 4, and older models running iOS 5.0.1 and curious how to use it on your own device?. This jailbreak won’t yet work with newer, Apple A5 chipset-powered devices, namely the iPhone 4S or...
Perception of inappropriate care frequent among ICU workersPublic release date: 27-Dec-2011 [ | E-mail | Share ]
Contact: Ruth D. Piers, M.D. ruth.piers@ugent.be JAMA and Archives Journals
CHICAGO A survey of nurses and physicians in intensive care units (ICUs) in Europe and Israel indicated that the perception of inappropriate care, such as excess intensity of care for a patient, was common, and that these perceptions were associated with inadequate decision sharing, communication and job autonomy, according to a study in the December 28 issue of JAMA.
"Clinicians perceive the care they provide as inappropriate when they feel that it clashes with their personal beliefs and/or professional knowledge. Intensive care unit workers who provide care perceived as inappropriate experience acute moral distress and are at risk for burnout. This situation may jeopardize the quality of care and increase staff turnover," according to background information in the article. The extent of perceived inappropriateness of care in the ICU is unknown.
Ruth D. Piers, M.D., of Ghent University Hospital, Gent, Belgium, and colleagues conducted a study to determine the prevalence and characteristics of perceived inappropriateness of care among clinicians in ICUs. The study consisted of an evaluation on May 11, 2010, of 82 adult ICUs in 9 European countries and Israel. The participants were 1,953 ICU nurses and physicians providing bedside care, who were surveyed regarding perceived inappropriateness of care, defined as a specific patient-care situation in which the clinician acts in a manner contrary to his or her personal and professional beliefs.
Of the 1,651 clinicians who provided responses, 439 (27 percent) reported perceived inappropriateness of care in at least 1 patient. Of the 1,218 nurses who completed the perceived inappropriateness of care questionnaire, 300 (25 percent) reported perceived inappropriateness of care. Of the 407 ICU physicians who provided care, 132 (32 percent) reported perceived inappropriateness of care in at least 1 of their patients.
In all, 397 clinicians completed 445 perceived inappropriateness of care questionnaires. Perceived disproportionate care was the most common reported reason (65 percent) for perceived inappropriateness of care; in 89 percent of these cases, the amount of care was perceived as excessive and in 11 percent as insufficient. Feeling that other patients would benefit more from ICU care than the present patient was the second most common reason (38 percent) for perceived inappropriateness of care. This feeling of distributive injustice was significantly more common among physicians than among nurses, the authors write.
Analysis indicated that several factors were independently associated with lower perceived inappropriateness of care rates: decisions about symptom control shared by nurses and physicians as opposed to being made by the physicians only; involvement of nurses in end-of-life decisions; good collaboration between nurses and physicians; work autonomy (freedom to decide how to perform work-related tasks); and perceived lower workload (only among nurses).
"In conclusion, perceived inappropriateness of care is common among nurses and physicians in ICUs and is significantly associated with an intent to leave the current clinical position, suggesting a major impact on clinician well-being. The main reported reason for perceived inappropriateness of care is a mismatch between the level of care and the expected patient outcome, usually in the direction of perceived excess intensity of care," the researchers write.
The authors add that the challenge for ICU managers is "to create ICUs in which self-reflection, mutual trust, open communication, and shared decision making are encouraged in order to improve the well-being of the individual clinicians and, thereby, the quality of patient care."
(JAMA. 2011;306[24]:2694-2703. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Perceived Inappropriateness of Care in the ICU
In an accompanying editorial, Scott D. Halpern, M.D., Ph.D., of the University of Pennsylvania, Philadelphia, writes that "although the report by Piers et al provides a hazy lens through which to view appropriateness of care, it yields more clarity than prior studies."
"Thus, the greatest contribution of [this study] may be to provide the clarion call needed to spur more rigorous study of what happens to clinicians and the care they provide when requests for care do not resonate with clinicians' conceptions of appropriateness. Such clinician-centered outcomes research, in other words, may usefully supplement the patient's perspective in gauging the quality of health care delivery."
(JAMA. 2011;306[24]:2725-2726. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.
To contact Ruth D. Piers, M.D., email ruth.piers@ugent.be. To contact editorial author Scott D. Halpern, M.D., Ph.D., call Jessica Mikulski at 215-349-8369 or email jessica.mikulski@uphs.upenn.edu.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Perception of inappropriate care frequent among ICU workersPublic release date: 27-Dec-2011 [ | E-mail | Share ]
Contact: Ruth D. Piers, M.D. ruth.piers@ugent.be JAMA and Archives Journals
CHICAGO A survey of nurses and physicians in intensive care units (ICUs) in Europe and Israel indicated that the perception of inappropriate care, such as excess intensity of care for a patient, was common, and that these perceptions were associated with inadequate decision sharing, communication and job autonomy, according to a study in the December 28 issue of JAMA.
"Clinicians perceive the care they provide as inappropriate when they feel that it clashes with their personal beliefs and/or professional knowledge. Intensive care unit workers who provide care perceived as inappropriate experience acute moral distress and are at risk for burnout. This situation may jeopardize the quality of care and increase staff turnover," according to background information in the article. The extent of perceived inappropriateness of care in the ICU is unknown.
Ruth D. Piers, M.D., of Ghent University Hospital, Gent, Belgium, and colleagues conducted a study to determine the prevalence and characteristics of perceived inappropriateness of care among clinicians in ICUs. The study consisted of an evaluation on May 11, 2010, of 82 adult ICUs in 9 European countries and Israel. The participants were 1,953 ICU nurses and physicians providing bedside care, who were surveyed regarding perceived inappropriateness of care, defined as a specific patient-care situation in which the clinician acts in a manner contrary to his or her personal and professional beliefs.
Of the 1,651 clinicians who provided responses, 439 (27 percent) reported perceived inappropriateness of care in at least 1 patient. Of the 1,218 nurses who completed the perceived inappropriateness of care questionnaire, 300 (25 percent) reported perceived inappropriateness of care. Of the 407 ICU physicians who provided care, 132 (32 percent) reported perceived inappropriateness of care in at least 1 of their patients.
In all, 397 clinicians completed 445 perceived inappropriateness of care questionnaires. Perceived disproportionate care was the most common reported reason (65 percent) for perceived inappropriateness of care; in 89 percent of these cases, the amount of care was perceived as excessive and in 11 percent as insufficient. Feeling that other patients would benefit more from ICU care than the present patient was the second most common reason (38 percent) for perceived inappropriateness of care. This feeling of distributive injustice was significantly more common among physicians than among nurses, the authors write.
Analysis indicated that several factors were independently associated with lower perceived inappropriateness of care rates: decisions about symptom control shared by nurses and physicians as opposed to being made by the physicians only; involvement of nurses in end-of-life decisions; good collaboration between nurses and physicians; work autonomy (freedom to decide how to perform work-related tasks); and perceived lower workload (only among nurses).
"In conclusion, perceived inappropriateness of care is common among nurses and physicians in ICUs and is significantly associated with an intent to leave the current clinical position, suggesting a major impact on clinician well-being. The main reported reason for perceived inappropriateness of care is a mismatch between the level of care and the expected patient outcome, usually in the direction of perceived excess intensity of care," the researchers write.
The authors add that the challenge for ICU managers is "to create ICUs in which self-reflection, mutual trust, open communication, and shared decision making are encouraged in order to improve the well-being of the individual clinicians and, thereby, the quality of patient care."
(JAMA. 2011;306[24]:2694-2703. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Perceived Inappropriateness of Care in the ICU
In an accompanying editorial, Scott D. Halpern, M.D., Ph.D., of the University of Pennsylvania, Philadelphia, writes that "although the report by Piers et al provides a hazy lens through which to view appropriateness of care, it yields more clarity than prior studies."
"Thus, the greatest contribution of [this study] may be to provide the clarion call needed to spur more rigorous study of what happens to clinicians and the care they provide when requests for care do not resonate with clinicians' conceptions of appropriateness. Such clinician-centered outcomes research, in other words, may usefully supplement the patient's perspective in gauging the quality of health care delivery."
(JAMA. 2011;306[24]:2725-2726. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.
To contact Ruth D. Piers, M.D., email ruth.piers@ugent.be. To contact editorial author Scott D. Halpern, M.D., Ph.D., call Jessica Mikulski at 215-349-8369 or email jessica.mikulski@uphs.upenn.edu.
###
[ | E-mail | Share ]
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
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Public release date: 27-Dec-2011
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