On September 2, 2011, at 2323 hours, a 32-year-old male volunteer fire fighter ('the FF') was dispatched via mutual aid to a campground structure fire. The FF arrived at the scene at 0014 hours on September 3, 2011, and staged for about 45 minutes. Then, while wearing full turnout gear, he assisted in exterior overhaul operations for about 15 minutes, before being assigned to rehabilitation (Rehab). Weather conditions included a temperature of 76 degrees Fahrenheit (DGF) and 79relative humidity, giving a heat index of 77DGF and a wet bulb globe temperature of 71DGF (NOAA 2011). Wet bulb globe temperature is a measure of ambient air temperature cooled by the evaporation of water from the wet temperature sensing element (NIOSH 1986). Shortly after climbing a 300-foot hill to the Rehab area, the FF collapsed and became unresponsive. Crewmembers began cardiopulmonary resuscitation (CPR) as the on-scene ambulance paramedics provided advanced life support treatment and transported the FF to the hospital's emergency department (ED). Treatment in the ED continued for 17 minutes but the resuscitation effort was not successful and the FF died. Two other fire fighters also suffered heat-related illnesses, one requiring treatment at the ED. The death certificate, completed by the County Coroner, listed 'cardiac arrhythmia due to focal severe coronary artery disease' as the cause of death. The autopsy report, completed by the County Medical Examiner, listed 'cardiac arrhythmia resulting from severe focal atherosclerosis of his left anterior descending coronary artery with clot formation' as the cause of death. Given the FF's underlying coronary heart disease, NIOSH investigators concluded that the physical stress of exterior overhaul activities triggered his heart attack (myocardial infarction as diagnosed by the coronary artery blood clot (thrombus)), arrhythmia, and subsequent cardiac death. NIOSH investigators offer the following recommendations to address safety and health issues and prevent similar incidents in the future. 1. Provide preplacement and annual medical evaluations to all fire fighters consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Phase in a mandatory comprehensive wellness and fitness program for fire fighters. 3. Perform an annual physical performance (physical ability) evaluation for all members. 4. Measure carboxyhemoglobin levels on symptomatic or unresponsive fire fighters exposed to fire smoke.

关键词：康复技术；急救人员；心脏病发作；心血管疾病；心血管系统疾病

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We are one-year into the three-years of our research program into the immunogenetic and drug exposure factors that contribute to chronic pain following spinal cord injury. Owing to the planned data collection timeline of the 2 studies in this program we have no raw data to report, but we have made significant administrative advances. Study 1 comprises two study sites, South Australia (site 1) and New South Wales (site 2). We have received human research ethics approval from the Royal Adelaide Hospital (site 1) and the New South Wales approval is under review. Study 1 has been approved by the Human Research Protection Office (16986.1). Our clinical team at Site 1 (Hampstead Rehabilitation Centre, Royal Adelaide Hospital) has identified 244 patients in their database who fulfill the inclusion criteria for Study 1. They have been processing 20-30 recruitment and questionnaire/sample mail-outs per week. The aim is to have exhausted the Site 1 subject list by the end of 2012 and have begun Site 2 (NSW) recruitment in 2013. Study 2 institutional Ethics approval has been gained and is being reviewed by the Human Research Protection Office (16986.2). We are on track to start Study 2 in 2013 as planned.

关键词：康复技术；临床医学；免疫原；脊髓损伤

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The current proposal aims to explore the relationship between brain function and connectivity in selective pathways/circuits, neuropsychological functioning, and cognitive rehabilitation response in Veterans with both Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD). Toward this end, we propose a randomized clinical trial involving a cognitive rehabilitation intervention that targets improved executive functioning, with the participation of N=100 Veterans diagnosed with both TBI and PTSD (n=50 experimental/n=50 control). We have just begun recruitment three months ago and enrolled n=15 dyads of veterans and family members at this point.

关键词：康复技术；创伤后应激障碍；创伤性脑损伤；临床试验

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In this twenty-first annual legislatively-mandated report, 2009 and 2010 DUI data from diverse sources were compiled and cross-referenced for the purpose of developing a single comprehensive DUI data reference and monitoring system. This report presents crosstabulated information on DUI arrests, convictions, court sanctions, administrative actions and alcohol-involved crashes. In addition, this report provides 1-year proportions of DUI recidivism and crash rates for first and second DUI offenders arrested in each year over a time period of 20 years. Also, the long term recidivism curves of the cumulative proportions of DUI reoffenses are shown for all DUI offenders arrested in 1994. Two analyses were conducted to evaluate if referrals to DUI programs were associated with reductions in 1-year subsequent violations and crashes among those convicted of the reduced charge of alcohol-related reckless driving, and if referrals to the 9-month DUI program were associated with reductions in 1-year subsequent violations and crashes when compared to referrals to the 3-month DUI program among first DUI offenders. The proportions of convicted first and second DUI offenders arrested in 2009, who were referred, enrolled, and completed DUI programs are also presented.

关键词：康复技术；管理信息系统；报告系统；酒精康复

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In October 2011, the Institute of Medicine (IOM) released the report Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence, assessing the published evidence for the effectiveness of using cognitive rehabilitation therapy (CRT) to treat people with traumatic brain injury (TBI). TBI has gained increasing attention in the past 15 years because of its status as the signature wound of American military conflicts in Iraq and Afghanistan. Growing numbers of U.S. service members are suffering traumatic brain injuries and are surviving them, given that (a) the majority of traumatic brain injuries are mild and (b) lifesaving measures for more severe injuries have significantly improved. People with any level of injury can require ongoing health care in their recovery, helping them to regain (or compensate for) their losses of function and supporting their full integration into their social structure and an improved quality of life.

关键词：脑；创伤科；康复技术；精神卫生

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This grant consists of three projects, each with its own investigative team, as described below. Program 1: Establishing the Parameters of Virtual Reality Environments in the Treatment of PTSD (Tracie Shea, Ph.D. lead investigator). This project has obtained local IRB approval and pre- approval from the DoD. Hardware has been tested and validated and subject recruitment will begin with DoD HRPO approval. Program 2: Framework for Comparison of Display Technologies as Routes of VR Exposure (Samuel Fulcomer, Lead Investigator). This project is studying the usage of the Virtual Iraq scenario to run on advanced multi-panel displays and the development of new display technology. These studies are concentrating on the technical adaptation of the current scenarios designed for head mounted displays to more high fidelity advanced display techniques. Solution of these technical difficulties will make this display technology suitable for a variety of VA, DoD, and civilian environments. Program 3A: Identifying Clinically Meaningful Improvement in Rehabilitation of Lower-Limb Amputees (Linda Resnik, Ph.D., P.T., O.C.T, Lead Investigator). This program was closed last year and is no longer generating information. Program 3B: Analysis of Gait Mechanics of Amputees Using a New Lower Limb Prosthesis (Matthew Williams, Ph.D.). The gait lab has been established in a new facility and is being used to quantify human motion in a variety of research projects. Program 4: Virtual reality and Motion Analysis to Characterize Disabilities in Lower Limb Injury (Susan D andrea, Ph.D., lead investigator). This project focuses on the use of virtual reality as a tool to assess physical function. The project will utilize information gather using VR with an emulated injury and apply similar procedures to assess patients with ACL injury to document functional mobility from injury onset through rehabilitation. Currently, local IRB approval is being sought for this project.

关键词：康复技术；截肢者；骨头；创伤后应激障碍

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关键词：康复技术；截肢者；创伤科；四肢；精神卫生

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Substantial population declines since the 1800s led the State of Michigan to list lake sturgeon as a threatened species. The primary causes of the decline of lake sturgeon are insufficient recruitment due to habitat loss and degradation, often caused by dams and poor spawning habitat quality, and excess mortality on adults through fishing. This document provides guidance for the management of lake sturgeon with the goal of eventually rehabilitating this species to the point of removal from the threatened species list and to levels that provide productive and unique fishery opportunities. The primary goals for lake sturgeon are to: (1) conserve populations that are currently self-sustaining; and (2) rehabilitate depressed populations to the point that they are self-sustaining at a higher level of abundance. Currently, there are 24 lake sturgeon populations as distinguished by major watersheds in Michigan waters: two in the Lake Superior drainage, 11 in the Lake Michigan drainage, nine in the Lake Huron drainage, and two in the Lake Erie/Lake St. Clair complex. Of these 24 populations, only five are large in size and three of these are considered to be abundant and stable enough to support harvest fisheries. Among the remaining 19 populations, 12 are below the minimum viable population size (80 adults) and are at high risk of extirpation due to random factors. Four populations are classified as small in size (80200 adults) and are at a high risk of declining to below the minimum viable population size. Three populations are classified as medium in size (200750 adults).

关键词：康复技术；鱼；湖鲟鱼；人居质量；死亡率

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The study is a 12-month randomized controlled trial comparing supported employment (SE) plus Cognitive Symptom Management and Rehabilitation Therapy (CogSMART), or SE-Cog, to enhanced supported employment (ESE) for OEF/OIF veterans with mild to moderate traumatic brain injury (TBI) who are unemployed and want to return to work. CogSMART is a manualized, 12-week compensatory cognitive training intervention designed to provide the following: (1) psychoeducation; (2) strategies to address sleep problems, fatigue, headaches, and stress; and (3) strategies to improve prospective memory, attention, learning/memory, and executive functioning. Assessments of cognition, postconcussive symptoms, psychiatric symptoms, functional skills, and quality of life will be administered at baseline, and at 3, 6, and 12 months following study enrollment. Work outcomes (i.e., weeks and hours worked, wages earned) will be measured weekly during the 12-month study. Results thus far indicate that CogSMART has robust effects on postconcussive symptoms as well as some aspects of neuropsychological performance. In addition, there are CogSMARTassociated trends toward improvement in depressive symptom severity and quality of life. These results suggest that CogSMART, in the context of supported employment, may improve postconcussive symptoms and cognitive performance as well as more distal outcomes such as depressive symptoms, quality of life, and potential work outcomes.

关键词：干预；康复技术；培训；创伤性脑损伤

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The goal of this project is to develop an innovative manufacturing process for Type IV high-pressure hydrogen storage vessels, with the intent to significantly lower manufacturing costs. Part of the development is to integrate the features of high precision AFP and commercial FW. Evaluation of an alternative fiber to replace a portion of the baseline fiber will help to reduce costs further.

关键词：储氢;压力容器;费用;评估;纤维

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