Most disaster plans depend on using emergency physicians, nurses, emergency department support staff, and out-of-hospital personnel to maintain the health care system's front line during crises that involve personal risk to themselves or their families. Planners automatically assume that emergency health care workers will respond. However, we need to ask: Should they, and will they, work rather than flee? The answer involves basic moral and personal issues. This article identifies and examines the factors that influence health care workers' decisions in these situations. After reviewing physicians' response to past disasters and epidemics, we evaluate how much danger they actually faced. Next, we examine guidelines from medical professional organizations about physicians' duty to provide care despite personal risks, although we acknowledge that individuals will interpret and apply professional expectations and norms according to their own situation and values. The article goes on to articulate moral arguments for a duty to treat during disasters and social crises, as well as moral reasons that may limit or override such a duty. How fear influences behavior is examined, as are the institutional and social measures that can be taken to control fear and to encourage health professionals to provide treatment in crisis situations. Finally, the article emphasizes the importance of effective risk communication in enabling health care professionals and the public to make informed and defensible decisions during disasters. We conclude that the decision to stay or leave will ultimately depend on individuals' risk assessment and their value systems. Preparations for the next pandemic or disaster should include policies that encourage emergency physicians, who are inevitably among those at highest risk, to "stay and fight."
ABSTKACT Advantages and dlsadvantayes of a funnel-shaped growth In 2 coral species (.4cropora clat111-ata, Jurblnana peltata) in a high-sedimentation environment (Natal, South Afr~ca) were observed in the field and modeled In a flow tank Funnel-shaped growth servcs different purposes in d~fferent hydrographic settings In calm waters w~t h l~ttle currents (in our casr deep reef areas, 18 to 25 m) funnel-qhaped colonres served as ' s a c r~f~c~a l sediment traps'. all sediment trapped inside the funnel was dirrcted towards the centre, c v h e r~ ~t was concentrated. There, tissues undertuent necroses, but all other tissues r e m a~n e d sedinient free and healthy In areas w~t h 111rlh currents (in our case shallower reef areas with high surge. 8 to 14 m ) funncls tended to be self-c-ltlan~nq By a PI-ocess of vortex shedd~n g , mass replacement ot f l~~~d w~t h i n thi. funnel also led to the ~enlovdl of all sediment. Current speeds between 30 and 90 cm s ' \vprcJ enough to clean the funnels of 3 exper~rnental grain si?es (coarse, flne, m e d~u m sand) K E Y WORDS: Coral S e d~m e n t Shap. Ecology South Afnca
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1. A Harris' hawk with a mass of 0.702 kg and a maximum wing span of 1.02 m glided freely in a wind tunnel at air speeds between 6.1 and 16.2ms−1. The glide angle varied from 8.5% at the slowest speed to a minimum of 5% at speeds between 8.0 and 14.7 ms−1. The maximum ratio of lift to drag was 10.9 and the minimum sinking speed was 0.81ms−1 2. Wing span decreased when either air speed or glide angle increased. Wing area was a parabolic function of wing span 3. Lift and profile drag coefficients of the wings fell in a polar area similar to that for a laggar falcon (Falco jugger) and a black vulture (Coragyps atratus). A single polar curve relating lift coefficients to minimum profile drag coefficients can predict the maximum gliding performance of all three birds when used with a mathematical model for gliding flight 4. The parasite drag values that have been used with the model are probably too high. Thus, the profile drag coefficients determined from the polar curve mentioned above are too low, and the predicted wing spans for gliding at maximum performance are too large. The predicted curve for maximum gliding performance is relatively unaffected 5. The maximum lift coefficient for the Harris' hawk in the wind tunnel was 1.6. This value is probably less than the maximum attainable, since the hawk's wings never appeared to stall. The best estimate of the minimum profile drag coefficient is 0.026 at a lift coefficient of 0.60.
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