Recent Events

In spite of this and other warnings, most primary care physicians have spent little time planning for terrorism. One reason may be the rarity of these events, especially on US soil. Until recently, the only reported case of bioterrorism in the United States was the 1984 salmonella attack in Oregon. It is unlikely that authors of family medicine textbooks written before September 2001 considered devoting significant space for discussions about how family physicians should respond to terrorist attacks. 

On October 4, 2001, the CDC and their state and local partners reported a case of inhalational anthrax in Florida (11). Over the following several weeks, pnblic health anthorities reported additional cases from Florida and New York City. Investigations revealed that the intentional release of Bacillus anthracis was responsible for these cases (12). By November 9, 22 cases (17 confirmed and five suspected) of bioterrorism-related anthrax were reported from Washington DC, Florida, New Jersey, and New York City (13). Ten of these cases were the inhalational form, resnlting in four deaths the other 12 cases were cutaneous anthrax. Of the ten inhalation cases, most were people who had processed, handled, or received letters containing B. anthracis spores. 

These events illustrate how family physicians and other primary care clinicians have been and will be on the front line in detecting and responding to terrorist threats and events. We can summarize their roles  

This book provides information useful for primary care clinicians in performing these roles including  

Malloy, CD. A History of Biological and Chemical Warfare and Terrorism. Public Health Issues in Disaster Preparedness. Focus on Bioterrorism. Journal of Public Health Management and Practice, 6(4). Aspen Publishers, Gaithersburg Maryland. Pps 85-92, 2001 

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Dwelling in the past Groups under stress tend to concentrate on explaining facts which have already been superseded by more recent events. 

Often referred to as short-term memory loss , this form of amnesia results in the inability to transfer new events to long term memory. The sufferer will still be able to recall older memories but will not be able to remember recent events once attention has been switched to something else. 

The full appreciation of the overriding importance of metal speciation in evaluating the transport and effects of metals in an environment is a relatively recent event. As more information is gathered on the forms in which metals exist and are transported through various environmental compartments, it will become possible to predict more accurately the response of the biological communities exposed to the metals and hopefully avert or mitigate the adverse effects. 

In this introductory chapter, a broad overview is given of the history of chemical warfare on earth, and the compounds, species, and mechanisms involved. The impact of human-made compounds on the environment, which is the subject of this book, is an extremely recent event in evolutionary terms. It is important to take a holistic view, and to see the effects of human-made pollutants on the environment against the background of chemical warfare in nature. 

PET Positron-emission tomography REM Rapid eye movement recent event memory... 

Although benzene has recently come under increasing control because of its alleged role in leukemia and other neoplastic diseases, in past years it has been widely dispersed in commercial uses and has entered the environment through many routes. In 1977, SRI attempted to characterize "Human Exposures to Atmospheric Benzene" (1). Most of the following examples come from that report, even though several later studies have updated and refined that work, and recent events have changed exposure patterns. 

A few recent events make it particularly interesting to valuate the fire hazard resulting from the burning of PVC materials, when they are present in a plenum. These include the recent regulations promulgated in New York State regarding the creation of a data base for smoke... 

Recent events since the industrial revolution have significantly altered the environmental conditions existing at many locations of our planet. Man has profoundly accelerated the... 

Patient has difficulty remembering recent events. Abilily to manage finances, prepare food, and carry out other household activities declines. May get lost while driving. Begins to withdraw from difficult tasks and to give up hobbies. May deny memory problems. 

Patient requires assistance with activities of daily living. Frequently disoriented with regard to time (date, year, season). Recall for recent events is severely impaired. May forget some details of past life and names of family and friends. Functioning may fluctuate from day to day. Patient generally denies problems. May become suspicious or tearful. Loses ability to drive safely. Agitation, paranoia, and delusions are common. 

Physical symptoms may include fatigue, pain (especially headache), sleep disturbance, appetite disturbance (decreased or increased), loss of sexual interest, and GI and cardiovascular complaints (especially palpitations). Intellectual or cognitive symptoms may include decreased ability to concentrate or slowed thinking, poor memory for recent events, confusion, and indecisiveness. 

Ever since the inception of the petroleum industry the level of fires, explosions and environmental pollution that have precipitated from it, has generally paralleled its growth. As the industry has grown so has the magnitude of its accidental events. Relatively recent events such as the Flixborough incident (1974), Occidental s Piper Alpha disaster (1988), and Exxon s Valdez oil spill (1989) have all amply demonstrated the extreme financial impact these accidents can produce. 

We are not expecting a smallpox attack, but the recent events that include the use of biological agents as weapons have heightened our awareness of the possibility of such an attack. 

Two recent events allow a more detailed picture of the solubility of hydrogen, nitrogen, oxygen, and the noble gases in water to be given, than could have been given even a year ago. First, a careful compilation and evaluation of the gas solubility values in water at a gas partial pressure of one atm between the temperatures of 273.15 and about 350 K was carried out by Battino [1 —5]. Second, an experimental study of the solubility of the noble gases in water at moderate pressures and at temperatures up to 561 K by a new method was reported by Potter and Clynne [6J. 

All the methods described above have been amenable to continuous monitoring as the reaction proceeded. In this section the batch procedure is described, in which aliquots of the reaction mixture are removed at various times and analyzed. Although the batch method is tedious it must be used to study certain exchange reactions and when the quenched-flow technique is used (Sec. 3.3.2). Recent events have suggested that batch analysis of a reacting system may give vital information not easily obtained by routine spectral analysis, see the next section. 

Worldwide data are not readily available as many nations do not publish the results of their animal residue monitoring programs. The best available data are those published regularly by the Food Safety Inspection Service (FSIS) of the U.S. Department of Agriculture (USDA). It is possible to go back over data for many years and demonstrate improvements in the residue situation, however the records for the past few years are the important ones as they are representative of current or recent events. Since the publication of worldwide residue data is at best sparse and not consistent, this chapter has made use of the regularly published residue data from the FSIS/USDA surveys, which are available on the Internet. The assumption made in this chapter, and perhaps there is a certain naivete to this assumption, is that international residue usage is similar to that found by the FSIS/USDA. This assumption is based upon the frequency of residues found in meat products imported into the U.S. 

Recent events, including the World Trade Center and Pentagon terrorist attacks of September 11, 2001, have induced rapid fundamental changes from historical perspectives of constitutional rights and governmental interests. Necessary questions to ask are (1) does the technology, practice, and procedure make society safer or provide an illusion of safety (2) is the privacy intrusion proportional to the security benefit and (3) are there other demonstrable less privacy intrusive methods available that attain the same objective. 

Does (s)he have more trouble remembering conversations, recent events, or appointments ... 

Episodic memory Inability to recall recent events... 

Schwarz, Ted. Kids and Guns The History, the Present, the Dangers, and the Remedies. New York Franklin Watts, 1999. For young readers. Gives an overview of the history and issues involved in gun control, including recent events, facts, and statistics. 

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