Philadelphia conducting experiment to save gunshot victims

“This might be a situation where more isn’t better.”

Joann Taylor, a block captain, retorted: “We’re already gambling with people’s lives.”

It is being headed by Temple University Hospital’s chief of surgery, Dr.

“All of the evidence we have points to us being right, but if we are wrong, we will end the study early,” Maher told the community group.

“You’re using people to do this study,” said Charles Lanier, head of a neighborhood revitalization group. They can obtain a wristband by filling out a form online or on paper.

Dr. “I hear what you’re saying, but in the interim, you’re still sacrificing somebody to prove which (method) is better.”

“If we said we were going to give another medicine, people would tend to go, ‘Let’s see if this works,'” he said. As part of the process, Dr. But supporters of the study say that for victims who are bleeding through an open wound, these procedures may cause an increase in blood pressure that can accelerate blood loss and death.

Maher, who is white, gave a 20-minute slideshow at a recent meeting in Hunting Park, a largely black and Hispanic neighborhood. Patrick Reilly, trauma chief at Penn Presbyterian Hospital, a study partner, said doctors and society tend to think more is better.

PHILADELPHIA (AP) — In all of last year, there were only 22 days when someone wasn’t shot in Philadelphia. Her audience was initially dubious.

Karen Maschke, a scholar at the Hastings Center, a medical ethics think tank in suburban New York City, said the experiment appears ethically sound.

A version of this experimental approach is already in place.

It’s a counterintuitive approach that could test long-held beliefs and change practices at trauma centers across the country.

Temple has been working for five years to set up the study. It could end early if researchers are able to prove or disprove their theory sooner.

During the study, paramedics treating adults who have been shot or stabbed in the torso will, on a random basis, not insert a tube down a victim’s throat or administer intravenous fluids – two traditional life-saving techniques some doctors say may actually harm such patients.

The Temple surgeon patiently laid out her case, even as she acknowledged the selection process is “like the flip of a coin.” Retrospective studies, she said, have shown that gunshot and stabbing victims given basic life support – such as an oxygen mask, CPR or immobilization – had an 18 percentage-point survival advantage over those given advanced procedures, such as intubation, in an ambulance.

For a generation, many Philadelphia police officers, instead of waiting for an ambulance, have been taking shooting and stabbing victims to the ER in their cruisers, a practice known as “scoop-and-run.” Data from the longstanding practice helped inform the surgeons proposing this study.

The study, involving all six of Philadelphia’s trauma hospitals, has been exempted from the Food and Drug Administration’s informed-consent rules, which require research subjects to be told the risks and benefits and to give permission in advance – something not feasible with gravely wounded people.

And every resident of or visitor to Philadelphia could become a study subject, though the biggest effect will probably be in the most violent neighborhoods – poor, mostly black sections where people are skeptical of essentially being experimented on.

. Zoe Maher, a Temple trauma surgeon, has been giving presentations at community forums.

Yanitza Gonzalez, a councilwoman’s representative, chimed in: “It’s almost like we’re gambling with people’s lives.”

Philadelphians who don’t want to participate in the study if they are ever wounded can opt out by wearing wristbands indicating their wishes. “Sometimes that’s going to mean you can’t stop and ask people if it’s OK.”

Now, in a bold effort to stem the bloodshed, several Philadelphia hospitals are about to conduct a citywide experiment that will ask: When gunshot or stabbing victims are being rushed to the emergency room by ambulance, could paramedics do more to save them by doing less?

“If this is not a public health crisis, I don’t know what is,” she said.

Some paramedics have opted out of participating.

Organizers had to meet certain requirements before launching the study, including getting approval from city and hospital review boards that oversee research on humans, holding community meetings and informing a certain percentage of the public.

Last year, there were 236 homicides in Philadelphia and more than 1,200 shootings, or one roughly every seven hours. Nearly 1 in 5 victims died.

The study is expected to start in the fall and last five years, or until doctors have about 1,000 patients, whichever comes first. Amy Goldberg, who has treated thousands of shooting victims in the three decades she has worked in Philadelphia.

“Getting to the emergency room, where equipment and experts are waiting, is a really critical window, especially for people with any kind of wound that involves bleeding,” said Maschke, editor of the journal IRB: Ethics & Human Research. Of those victims, nearly 700 were black men ages 18 to 34.

Normally, paramedics intubate patients to keep their airway open, and give IV fluids to counteract a drop in blood pressure

Gaming – InfoBarrel

From simple to complex, intellectual to sports related and the highly dynamic violent games, name it and you have a long list of choices.

- Dexterity/coordination games

- Simulation – Games of this type are extensions of childhood games where children pretend being in adult roles such as doctor, parent or fireman. Today these games are primarily electronic and cover a diversity of imaginary contexts that the modern computers try to recreate as a form of virtual reality.

“A game is a structured activity, usually undertaken for enjoyment and sometimes used as an educational tool. Here, online gamers met and have formed virtual camaraderie through the game preferences they had. In addition, such games are fairly simple to finish off, so gamers are not at all pressured to play for more hours.. A lot of games are now being introduced to the public. Furthermore, there are times when people would simply want to relax and play a game without having to deal with the other players. While games for offline gaming are still available and loved by some people, the majority already prefers the online games at present.

- Pencil and paper games

- Business games

There are many different types of games.

Gambling involves activities like casinos, sports books, poker, video poker, craps, black jack, roulette, slot machines, lottery and skill games – just to name a few. Knowing the trend in online gaming, it is expected that there’s more to come in the future that’s completely exciting. These games involve taking on the role of a character in the game and controlling the choices of the character while working with their strengths and weaknesses.

- Dice games: Backgammon , Dice Chess, Ship, Captain, and Crew (or Six Five Four), Shoot the Moons, Strat-O-Matic

Playing Games

To play online, you must register first to be qualified and enjoy the benefits of various online gamers club. As a member, you may avail of discounts on games for sale, get the freebies given to its member, and the opportunity to meet and play with other online games enthusiasts worldwide. But more than the prize being offered, online gamers are interested on the title for each competition. That is why more and more IT experts are religiously developing new games or simply improving the current prevailing games since there is a huge public clamor for such.

Offline Gaming

- Video games

Gambling

Information technology has certainly made a big impact to humankind. It has gained its popularity which led to the existence of arcades. Key components of games are goals, rules, challenge, and interaction. Even with the numerous online games available, offline gaming is still going to exist and probably preferred by some.

- Card games: Poker, Baccarat, Canasta – to name just the most popular and well known

Source

- Tabletop games

- Role-playing games (RPG) – These types of games can be played either in electronic format such as on a computer or video game console, some of them even being online like World of Warcraft, or they can be played as a tabletop game like White Wolf or Shadowrun. Attested as early as 2600 BC, games are a universal part of human experience and present in all cultures.” (en.wikipedia.org/wiki/Game)

These games require a PC or laptop, but an Internet connection is not needed. Some are old games that are just modified to fit with the modern times while some are totally new. In the case of The Sims 3, it can be played either in a computer or PS3 console. Games generally involve mental or physical stimulation, and often both. The classification made by Wikipedia goes like this:

Offline gaming is a cool way to fill in time and enjoy, especially when you cannot go online. Many games help develop practical skills, serve as a form of exercise, or otherwise perform an educational, simulational, or psychological role. One significant development has something to do with the way games are being played. Time, distance and nationality are defied in the so-called growing cyber world that gathers online gamers. And for these reasons, this is where offline gaming comes into play. By the year 1990, its popularity has hit the highest point, but eventually dropped since the market did not expand quickly as what was expected. Almost every aspect of human interest turned out to be very accessible. Watch out for that.

The Sims 3

Need for Speed: Shift

The Orange Box

The Elder Scrolls: Morrowind

Starcraft 2

- Sports – here is a list with the most popular sports games: Football, Soccer, Baseball, BasketBall, Hockey, Rugby, Volleyball, Pool Games, Water Games, Cricket, Boxing, Wrestling, Golf, Shooting, Horse Racing, Car Games, Driving Games, Cycling, Bowling, Dodge ball Games, Fishing , Hunting, Ice Skating, Olympics Games, Parking Games, Skateboard, Snowboarding, Surfing Games, Winter Games.

- Guessing games

Wikipedia, the free encyclopedia © 2001-2010 (en.wikipedia.org/wiki/Game)

Offline gaming began in the year 1970. They are really popular in both real and online world.

One reason why online gaming is such a major success is because of the competition being held on a particular game every now and then in which fabulous prizes are at stake. The thought of outwitting their counterparts is what drives any online gamer to succeed. But for you to fully appreciate online gaming, you should be aware of the technical aspects to secure a spot in what they call the elite circle of online gamers.

There are a number of popular games for offline gaming as:

Are you interested in playing games or in gambling? In real world, offline or online?

These games are available online and the best part of it is that you can now play with people from all over the world. Additionally, games for offline gaming are either skill-based or story-based, with the former as the more difficult as it needs your experience and skillfulness in order to play and finish the game.

- Domino and tile games

Online Gaming

- Board games: Monopoly, Go, Scrabble, Chess, The Settlers of Catan, Ticket to Ride, Maharaja, Backgammon, Taj Mahal, Mine a million, Torres, Lost Cities , Speachless, Logo board games, Masterpiece, Buzzle, Highlanders, History of the World, The Game of Life, Dominion, LifeStyle The Financial Planning Game

With offline gaming, the usual games could last around 20 to 100 game play hours

10 Steps You Can Take To Stop Gambling Today

Know that there are 1000’s of recovering gamblers. -Author Unknown.

STEP 7: REMIND YOURSELF WHY YOU’RE STOPPING, & FOR WHO.

Make a list of the people you love & love you back. If needed, list them out. If you want to stop starting right now, block all access to money. He’s overcome his own addiction to gambling & has helped many others do the same. In the beginning the constant thoughts and urges to gamble can be intense. If you gamble online, get gamblock today.

When you absolutely must stop gambling right now, here are 10 steps you can take today.

STEP 3: JOIN A COMMUNITY OF RECOVERING GAMBLERS

Recovering in numbers is key. Its best to find someone who’s been in your shoes, but hasn’t gambled in quite some time.

Make sure you like them, they have your best interest in mind, & truly do help you. Put up pictures of them & when you see it, remember that’s who you’re stopping for.

Recognize that if you gamble, you’re letting them down.

Remind yourself of all the bad things that have been caused by your obsession to gamble. Carrying recovery reading & phone numbers help. There are therapists, counselors, & life coaches out there trained to help you stop.

. Good help seems to come from ex-gamblers themselves because they’ve been there, & they understand. Have phone numbers listed for people to call who support you in your recovery. Combat this with the previous 9 steps & a one on one coach, sponsor, or therapist. Know what to do & who to call if a thought or urges to gamble hits you….(and unfortunately they will).

STEP 10: GET 1 ON 1 SUPPORT.

Stopping Gambling isn’t easy. The only time casinos won’t let you gamble, is when you don’t have what they want……money.

These 10 steps are an excellent start to stopping gambling today.

If you have any unanswered questions or need to be pointed in the right direction email jason@livegamblefree.com

Jason is a recovered compulsive gambler of over 5 years and a certified professional life coach. You help yourself and others triumph over a common enemy. (because it is the truth).

STEP 2: GET HELP TODAY

To overcome something as powerful as a gambling problem or addiction, we must get help from others.

Help is out there in many forms. Know that if they can do it, you can too. Don’t know where to turn to for help? Email jason@livegamblefree.com

STEP 4: SUBMIT YOURSELF TO A PROGRAM OF RECOVERY

What does this mean exactly? It means you must submit,commit, & trust in the program of recovery you choose. In the moment, you’ll want a plan of action to take when the urge to gamble attempts to overwhelm you.

To learn the secrets to stopping gambling now, & to get 1 on 1 coaching from Jason visit http://www.livegamblefree.com or email Jason at jason@livegamblefree.com

STEP 1: GET RID OF YOUR MONEY

If you want to stop gambling right now, the first step begins by stopping to carry money. Connect your gambling with the the negative consequences its brought into your life.

STEP 6: BAN YOURSELF FROM GAMBLING (ONLINE AND OFF)

If you go to a local casino, take a caring friend and ban yourself for life.

If you play online, contact the online casino and have your account closed permanently, & demand to be banned from their site. You trust that the program will solve your gambling problem, as long as you never give up on it.

STEP 5: CARRY RESOURCES WITH YOU AT ALL TIMES

Get or print off pro gambling recovery literature & carry it with you at all times.

Read it daily, especially in first months. A gambling problem is very strong, plays many tricks on on our minds, & tries to convince us of many lies. Carry only a very small budget for food each day and thats it.( absolutely no more than $5). Call them ANYTIME you need to.

STEP 9: HAVE A PLAN IN PLACE FOR YOUR NEXT URGE

When your next urge comes, what will you do? You’ll need to know the answer to this. You make lifelong friends who will always understand and care.

This step can be done by attending Gamblers Anonymous, Celebrate Recovery, & finding online support and help. Inpatient Treatment is another. This includes credit cards, debit cards, access to bank accounts, checks, loans, etc. (Email the author at jason@livegamblefree.com for online communities you can join today).

There is but one good throw upon the dice, which is, to throw them away. Gamblers Anonymous is one. There are 1000’s of people who once were severely addicted to gambling, haven’t gambled for months and even years. It may sound funny, but joining a group of fellow recovering gamblers gives you strength & power over your gambling. He is an author, life coach, sponsor, & former GA chapter president, husband, & stepfather.

Author’s Bio: 

STEP 8: STAY HOPEFUL

Only those who never give up on themselves & their program of recovery beat gambling