WorldWideScience

Sample records for casualty incidents planning

  1. Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

    Energy Technology Data Exchange (ETDEWEB)

    Greenwalt, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hibbard, W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-08-09

    Emergency response agencies in most US communities are organized, sized, and equipped to manage those emergencies normally expected. Hospitals in particular do not typically have significant excess capacity to handle massive numbers of casualties, as hospital space is an expensive luxury if not needed. Unfortunately this means that in the event of a mass casualty chemical incident the emergency response system will be overwhelmed. This document provides a self-assessment means for emergency managers to examine their response system and identify shortfalls. It also includes lessons from a detailed analysis of five communities: Baltimore, Boise, Houston, Nassau County, and New Orleans. These lessons provide a list of potential critical decisions to allow for pre-planning and a library of best practices that may be helpful in reducing casualties in the event of an incident.

  2. Mass Casualty Incident Primary Triage Methods in China

    Institute of Scientific and Technical Information of China (English)

    Jin-Hong Chen; Jun Yang; Yu Yang; Jing-Chen Zheng

    2015-01-01

    Objective:To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China.Data Sources:Chinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014).The English literature was searched by PubMed (MEDLINE) (1950 to June 2014).We also searched Official Websites of Chinese Central Government's (http://www.gov.cn/),National Health and Family Planning Commission of China (http://www.nhfpc.gov.cn/),and China Earthquake Information (http://www.csi.ac.cn/).Study Selection:We included studies associated with mass casualty events related to China,the PT applied in China,guidelines and standards,and application and development of the carding PT method in China.Results:From 3976 potentially relevant articles,22 met the inclusion criteria,20 Chinese,and 2 English.These articles included 13 case reports,3 retrospective analyses of MCI,two methods introductions,three national or sectoral criteria,and one simulated field testing and validation.There were a total of 19 kinds ofMCI PT methods that have been reported in China from 1950 to 2014.In addition,there were 15 kinds of PT methods reported in the literature from the instance of the application.Conclusions:The national and sectoral current triage criteria are developed mainly for earthquake relief.Classification is not clear.Vague criteria (especially between moderate and severe injuries) operability are not practical.There are no triage methods and research for children and special populations.There is no data and evidence supported triage method.We should revise our existing classification and criteria so it is clearer and easier to be grasped in order to build a real,practical,and efficient PT method.

  3. Mass Casualty Incident Response and Aeromedical Evacuation in Antarctica

    Directory of Open Access Journals (Sweden)

    Mills, Christopher N

    2011-02-01

    Full Text Available Antarctica is one of the most remote regions on Earth. Mass casualty incident (MCI responses in Antarctica are prone to complications from multiple environmental and operational challenges. This review of the current status of MCI risks and response strategies for Antarctica focuses on aeromedical evacuation, a critical component of many possible MCI scenarios. Extreme cold and weather, a lack of medical resources and a multitude of disparate international bases all exert unique demands on MCI response planning. Increasing cruise ship traffic is also escalating the risk of MCI occurrence. To be successful, MCI response must be well coordinated and undertaken by trained rescuers, especially in the setting of Antarctica. Helicopter rescue or aeromedical evacuation of victims to off-continent facilities may be necessary. Currently, military forces have the greatest capacity for mass air evacuation. Specific risks that are likely to occur include structure collapses, vehicle incapacitations, vehicle crashes and fires. All of these events pose concomitant risks of hypothermia among both victims and rescuers. Antarctica’s unique environment requires flexible yet robust MCI response planning among the many entities in operation on the continent. [West J Emerg Med. 2011;12(1:37-42.

  4. Portable ultrasonography in mass casualty incidents: The CAVEAT examination

    OpenAIRE

    Stawicki, Stanislaw Peter; Howard, James M; Pryor, John P; David P. Bahner; Whitmill, Melissa L; Dean, Anthony J

    2010-01-01

    Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently est...

  5. A mass casualty incident involving children and chemical decontamination.

    Science.gov (United States)

    Timm, Nathan; Reeves, Scott

    2007-01-01

    Mass casualty incidents involving contaminated children are a rare but ever-present possibility. In this article we outline one such event that resulted in 53 pediatric patients and 3 adults presenting to the emergency department of a children's hospital for decontamination and treatment. We pay special attention to the training that allowed this responses to occur. We also outline the institutional response with emphasis on incident command, communication, and resource utilization. Specific lessons learned are explored in detail. Finally, we set forth a series of recommendations to assist other institutions should they be called upon to care for and decontaminate pediatric patients.

  6. On constant alert: lessons to be learned from Israel's emergency response to mass-casualty terrorism incidents.

    Science.gov (United States)

    Adini, Bruria; Peleg, Kobi

    2013-12-01

    In its short modern history, Israel has had to contend with numerous mass-casualty incidents caused by terrorism. As a result, it has developed practical national preparedness policies for responding to such events. Israel's Supreme Health Authority, a committee of the Ministry of Health, coordinates emergency management nationwide. All emergency personnel, health care providers, and medical facilities operate under national policies designed to ensure a swift and coordinated response to any incident, based on an "all hazards" approach that emphasizes core elements commonly encountered in mass-casualty incidents. Israel's emergency management system includes contingency planning, command and control, centrally coordinated response, cooperation, and capacity building. Although every nation is unique, many of the lessons that Israel has learned may be broadly applicable to preparation for mass-casualty incidents in the United States and other countries.

  7. RFID based patient registration in mass casualty incidents

    Directory of Open Access Journals (Sweden)

    Nestler, Simon

    2011-01-01

    Full Text Available In MCIs (mass casualty incidents the EMC (emergency medical chief has to gain an overview on all patients at the scene. When using paper based patient tags the patient-related information remains at the patients themselves and the information relay is complex. We propose a mobile, RFID based solution, which makes the local patient-related information available to all relief workers at the scene. As a consequence all processes in an MCI are more transparent and the resulting medication and transport of the injured is more efficient. The introduction of RFID enhanced patient tags leads to various usability challenges which are discussed in this paper. Furthermore, three different implementations show, how these challenges can be solved in the future. These solutions have been evaluated in a disaster control exercise in order to get an impression of the practical suitability of the proposed solutions. The future introduction of RFID tags in rescue and emergency services can be based on this work.

  8. Self-care Decontamination within a Chemical Exposure Mass-casualty Incident.

    Science.gov (United States)

    Monteith, Raymond G; Pearce, Laurie D R

    2015-06-01

    Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate.

  9. Mass Casualty Decontamination in a Chemical or Radiological/Nuclear Incident with External Contamination: Guiding Principles and Research Needs.

    Science.gov (United States)

    Cibulsky, Susan M; Sokolowski, Danny; Lafontaine, Marc; Gagnon, Christine; Blain, Peter G; Russell, David; Kreppel, Helmut; Biederbick, Walter; Shimazu, Takeshi; Kondo, Hisayoshi; Saito, Tomoya; Jourdain, Jean-René; Paquet, Francois; Li, Chunsheng; Akashi, Makoto; Tatsuzaki, Hideo; Prosser, Lesley

    2015-11-02

    Hazardous chemical, radiological, and nuclear materials threaten public health in scenarios of accidental or intentional release which can lead to external contamination of people.  Without intervention, the contamination could cause severe adverse health effects, through systemic absorption by the contaminated casualties as well as spread of contamination to other people, medical equipment, and facilities.  Timely decontamination can prevent or interrupt absorption into the body and minimize opportunities for spread of the contamination, thereby mitigating the health impact of the incident.  Although the specific physicochemical characteristics of the hazardous material(s) will determine the nature of an incident and its risks, some decontamination and medical challenges and recommended response strategies are common among chemical and radioactive material incidents.  Furthermore, the identity of the hazardous material released may not be known early in an incident.  Therefore, it may be beneficial to compare the evidence and harmonize approaches between chemical and radioactive contamination incidents.  Experts from the Global Health Security Initiative's Chemical and Radiological/Nuclear Working Groups present here a succinct summary of guiding principles for planning and response based on current best practices, as well as research needs, to address the challenges of managing contaminated casualties in a chemical or radiological/nuclear incident.

  10. Using a joint triage model for multi-hospital response to a mass casualty incident in New York city

    Directory of Open Access Journals (Sweden)

    Arquilla Bonnie

    2009-01-01

    Full Text Available This paper defines a specific plan which allows two separate institutions, with different capabilities, to function as a single receiving entity in the event of a mass casualty incident. The street between the two institutions will be closed to traffic and a two-phase process initiated. Arriving ambulances will first be quickly screened to expedite the most critical patients followed by formal triage and directing patients to one of the two facilities. Preparation for this plan requires prior coordination between local authorities and the administrations of both institutions. This plan can serve as a general model for disaster preparedness when two or more institutions with different capabilities are located in close proximity.

  11. NATO Planning Guide for the Estimation of CBRN Casualties

    Science.gov (United States)

    2014-11-01

    Static Overpressure Thresholds for Declaration of KIA Due to Tertiary Nuclear Blast Effects...Casualty The methodology estimates casualties with regard to the medical system, not the personnel system. Thus, it estimates killed in action ( KIA ...Killed in Action ( KIA ): “a battle casualty who was killed outright or who died before reaching a medical treatment facility.”27 By definition, in this

  12. Research approaches to mass casualty incidents response:development from routine perspectives to complexity science

    Institute of Scientific and Technical Information of China (English)

    Shen Weifeng; Jiang Libing; Zhang Mao; Ma Yuefeng; Jiang Guanyu; He Xiaojun

    2014-01-01

    Objective To review the research methods of mass casualty incident (MCI) systematically and introduce the concept and characteristics of complexity science and artificial system,computational experiments and parallel execution (ACP) method.Data sources We searched PubMed,Web of Knowledge,China Wanfang and China Biology Medicine (CBM) databases for relevant studies.Searches were performed without year or language restrictions and used the combinations of the following key words:“mass casualty incident”,“MCI”,“research method”,“complexity science”,“ACP”,“approach”,“science”,“model”,“system” and “response”.Study selection Articles were searched using the above keywords and only those involving the research methods of mass casualty incident (MCI) were enrolled.Results Research methods of MCI have increased markedly over the past few decades.For now,dominating research methods of MCI are theory-based approach,empirical approach,evidence-based science,mathematical modeling and computer simulation,simulation experiment,experimental methods,scenario approach and complexity science.Conclusions This article provides an overview of the development of research methodology for MCI.The progresses of routine research approaches and complexity science are briefly presented in this paper.Furthermore,the authors conclude that the reductionism underlying the exact science is not suitable for MCI complex systems.And the only feasible alternative is complexity science.Finally,this summary is followed by a review that ACP method combining artificial systems,computational experiments and parallel execution provides a new idea to address researches for complex MCI.

  13. The development and features of the Spanish prehospital advanced triage method (META) for mass casualty incidents.

    Science.gov (United States)

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Garijo Gonzalo, Gracia; Martinez Monzon, Carlos; Pelaez Corres, Nieves; Rodriguez Soler, Alberto; Turegano Fuentes, Fernando

    2016-04-29

    This text describes the process of development of the new Spanish Prehospital Advanced Triage Method (META) and explain its main features and contribution to prehospital triage systems in mass casualty incidents. The triage META is based in the Advanced Trauma Life Support (ATLS) protocols, patient's anatomical injuries and mechanism of injury. It is a triage method with four stages including early identification of patients with severe trauma that would benefit from a rapid evacuation to a surgical facility and introduces a new patient flow by-passing the advanced medical post to improve evacuation. The stages of triage META are: I) Stabilization triage that classifies patients according to severity to set priorities for initial emergency treatment; II) Identifying patients requiring urgent surgical treatment, this is done at the same time than stage I and creates a new flow of patients with high priority for evacuation; III) Implementation of Advanced Trauma Life Support protocols to patients previously classified according to stablished priority; and IV) Evacuation triage, stablishing evacuation priorities in case of lacks of appropriate transport resources. The triage META is to be applied only by prehospital providers with advanced knowledge and training in advanced trauma life support care and has been designed to be implemented as prehospital procedure in mass casualty incidents (MCI).

  14. A lightning multiple casualty incident in Sequoia and Kings Canyon National Parks.

    Science.gov (United States)

    Spano, Susanne J; Campagne, Danielle; Stroh, Geoff; Shalit, Marc

    2015-03-01

    Multiple casualty incidents (MCIs) are uncommon in remote wilderness settings. This is a case report of a lightning strike on a Boy Scout troop hiking through Sequoia and Kings Canyon National Parks (SEKI), in which the lightning storm hindered rescue efforts. The purpose of this study was to review the response to a lightning-caused MCI in a wilderness setting, address lightning injury as it relates to field management, and discuss evacuation options in inclement weather incidents occurring in remote locations. An analysis of SEKI search and rescue data and a review of current literature were performed. A lightning strike at 10,600 feet elevation in the Sierra Nevada Mountains affected a party of 5 adults and 7 Boy Scouts (age range 12 to 17 years old). Resources mobilized for the rescue included 5 helicopters, 2 ambulances, 2 hospitals, and 15 field and 14 logistical support personnel. The incident was managed from strike to scene clearance in 4 hours and 20 minutes. There were 2 fatalities, 1 on scene and 1 in the hospital. Storm conditions complicated on-scene communication and evacuation efforts. Exposure to ongoing lightning and a remote wilderness location affected both victims and rescuers in a lightning MCI. Helicopters, the main vehicles of wilderness rescue in SEKI, can be limited by weather, daylight, and terrain. Redundancies in communication systems are vital for episodes of radio failure. Reverse triage should be implemented in lightning injury MCIs. Education of both wilderness travelers and rescuers regarding these issues should be pursued.

  15. Evaluation of a CT triage protocol for mass casualty incidents: results from two large-scale exercises

    Energy Technology Data Exchange (ETDEWEB)

    Koerner, Markus; Kroetz, Michael M.; Wirth, Stefan; Boehm, Holger F.; Reiser, Maximilian; Linsenmaier, Ulrich [University Hospital Munich, Department of Clinical Radiology, Munich (Germany); Huber-Wagner, Stefan; Kanz, Karl-Georg [University Hospital Munich, Department of Surgery, Munich (Germany)

    2009-08-15

    The purpose of this study was to evaluate the feasibility, stability, and reproducibility of a dedicated CT protocol for the triage of patients in two separate large-scale exercises that simulated a mass casualty incident (MCI). In both exercises, a bomb explosion at the local soccer stadium that had caused about 100 casualties was simulated. Seven casualties who were rated ''critical'' by on-site field triage were admitted to the emergency department and underwent whole-body CT. The CT workflow was simulated with phantoms. The history of the casualties was matched to existing CT examinations that were used for evaluation of image reading under MCI conditions. The times needed for transfer and preparation of patients, examination, image reconstruction, total time in the CT examination room, image transfer to PACS, and image reading were recorded, and mean capacities were calculated and compared using the Mann-Whitney U test. We found no significant time differences in transfer and preparation of patients, duration of CT data acquisition, image reconstruction, total time in the CT room, and reading of the images. The calculated capacities per hour were 9.4 vs. 9.8 for examinations completed, and 8.2 vs. 7.2 for reports completed. In conclusion, CT triage is feasible and produced constant results with this dedicated and fast protocol. (orig.)

  16. Evaluation of a CT triage protocol for mass casualty incidents: results from two large-scale exercises.

    Science.gov (United States)

    Körner, Markus; Krötz, Michael M; Wirth, Stefan; Huber-Wagner, Stefan; Kanz, Karl-Georg; Boehm, Holger F; Reiser, Maximilian; Linsenmaier, Ulrich

    2009-08-01

    The purpose of this study was to evaluate the feasibility, stability, and reproducibility of a dedicated CT protocol for the triage of patients in two separate large-scale exercises that simulated a mass casualty incident (MCI). In both exercises, a bomb explosion at the local soccer stadium that had caused about 100 casualties was simulated. Seven casualties who were rated "critical" by on-site field triage were admitted to the emergency department and underwent whole-body CT. The CT workflow was simulated with phantoms. The history of the casualties was matched to existing CT examinations that were used for evaluation of image reading under MCI conditions. The times needed for transfer and preparation of patients, examination, image reconstruction, total time in the CT examination room, image transfer to PACS, and image reading were recorded, and mean capacities were calculated and compared using the Mann-Whitney U test. We found no significant time differences in transfer and preparation of patients, duration of CT data acquisition, image reconstruction, total time in the CT room, and reading of the images. The calculated capacities per hour were 9.4 vs. 9.8 for examinations completed, and 8.2 vs. 7.2 for reports completed. In conclusion, CT triage is feasible and produced constant results with this dedicated and fast protocol.

  17. Factors influencing injury severity score regarding Thai military personnel injured in mass casualty incident April 10, 2010: lessons learned from armed conflict casualties: a retrospective study

    Directory of Open Access Journals (Sweden)

    Boonthep Nuttapong

    2012-01-01

    Full Text Available Abstract Background Political conflicts in Bangkok, Thailand have caused mass casualties, especially the latest event April 10, 2010, in which many military personnel were injured. Most of them were transferred to Phramongkutklao Hospital, the largest military hospital in Thailand. The current study aimed to assess factors influencing Injury Severity Score (ISS regarding Thai military personnel injured in the mass casualty incident (MCI April 10, 2010. Methods A total of 728 injured soldiers transferred to Phramongkutklao Hospital were reviewed. Descriptive statistics was used to display characteristics of the injuries, relationship between mechanism of injury and injured body regions. Multiple logistic regressions were used to calculate the adjusted odds ratio (adjusted OR of ISS comparing injured body region categories. Results In all, 153 subjects defined as major data category were enrolled in this study. Blast injury was the most common mechanism of injury (90.2%. These victims displayed 276 injured body regions. The most common injured body region was the extremities (48.5%. A total of 18 patients (11.7% had an ISS revealing more than 16 points. Three victims who died were expected to die due to high Trauma and Injury Severity Score (TRISS. However, one with high TRISS survived. Factors influencing ISS were age (p = 0.04, abdomen injury (adjusted OR = 29.9; 95% CI, 5.8-153.5; P P P Conclusions Blast injury was the most common mechanism of injury among Thai military personnel injured in the MCI April 10, 2010. Age and injured body region such as head & neck, chest and abdomen significantly influenced ISS. These factors should be investigated for effective medical treatment and preparing protective equipment to prevent such injuries in the future.

  18. Mass Casualty Decontamination in a Chemical or Radiological/ Nuclear Incident: Further Guiding Principles

    Science.gov (United States)

    Carter, Holly; Amlôt, Richard; Williams, Richard; Rubin, G. James; Drury, John

    2016-01-01

    This short report presents a response to an article written by Cibulsky et al. (2016). The paper by Cibulsky et al. presents a useful and timely overview of the evidence surrounding the technical and operational aspects of mass casualty decontamination. It identifies three priority targets for future research, the third of which is how casualties' needs can be met in ways that best support compliance with and effectiveness of casualty decontamination. While further investigation into behavioural, communication and privacy issues during mass decontamination is warranted, there is now a substantial body of research in this area which is not considered in detail in the succinct summary provided by Cibulsky et al. (2016). In this short report, we summarise the available evidence around likely public behaviour during mass decontamination, effective communication strategies, and potential issues resulting from a lack of privacy. Our intention is to help further focus the research needs in this area and highlight topics on which more research is needed.

  19. Marine Casualty and Pollution Data for Researchers

    Data.gov (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  20. Indoor fire in a nursing home : evaluation of the medical response to a mass casualty incident based on a standardized protocol

    NARCIS (Netherlands)

    Koning, S. W.; Ellerbroek, P. M.; Leenen, L. P. H.

    2015-01-01

    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent res

  1. Development of an accelerated MSCT protocol (Triage MSCT) for mass casualty incidents: comparison to MSCT for single-trauma patients.

    Science.gov (United States)

    Körner, M; Krötz, M; Kanz, K-G; Pfeifer, K-J; Reiser, M; Linsenmaier, U

    2006-07-01

    During multiple casualty incidents (MCI) emergency radiology departments have to deal with a large number of patients with suspected severe trauma within a short period of time. The aim of this study was to develop a suitable accelerated multislice computed tomography (MSCT) protocol to increase patient throughput for this kind of emergency situation. We presumed a scenario of 15 patients being admitted to the trauma service with suspicion of severe injuries after a MCI over a period of 2 h. An accelerated Triage MSCT protocol was developed and evaluated for MSCT scanner productivity (patients per hour) and time (minutes) needed for a total MSCT body workup using an anthropomorphic phantom. In addition, time (minutes) for transfer and preparation was measured. These timeframes were compared to a control group consisting of 144 single patients with multiple trauma undergoing standard MSCT according to our trauma room protocol. All MSCT studies were conducted using a 4-detector row scanner. (1) For the study group (Triage MSCT), average time for patient transfer and preparation was 2.9 min (2.5-4.3 min), mean CT examination time was 2.1 min (1.7-2.4 min); image reconstruction took 4.0 min (3.3-4.3 min). Total time in scanner room was 8.9 min (7.7-11.3 min), resulting in a maximal productivity of 6.7 patients per hour. Image transfer to the digital picture archive and communication system archive was completed after an average 9.5 min (8.9-10.8 min). (2) For the control group (single casualty MSCT), the mean time for patient transfer and preparation was 20.4 min (9.0-39.2 min), mean examination time was 6.0 min (3.1-11.3 min). Times for image reconstructions were not recorded in the patient series. Mean total time in scanner room was 25.3 min (11.0-72.4 min), resulting in a patient throughput of 2.4 patients per hour. MSCT has potential to serve as a powerful tool in triage of multiple casualty patients. The introduction of a Triage MSCT scanning protocol resulted in

  2. [Current state of medical care of polytrauma and mass casualty incidents in Germany. Are we well-prepared?].

    Science.gov (United States)

    Brodauf, L; Heßing, K; Hoffmann, R; Friemert, B

    2015-10-01

    The white paper on the medical care of the severely injured published in 2006 is a collection of proposals and recommendations concerning structure, organization and equipment for the medical care of severely injured patients. Since its publication 50 networks ( http://www.dgu-traumanetzwerk.de/index ) have been established as part of the trauma network. This and the trauma register have helped to continuously improve the medical care of severely injured patients since 1993 [26]. Numerous studies have documented the progress made in measures required by the trauma network [4, 6]. For example, the mortality rate of severely injured patients has dropped from 25 % to approximately 10 % in the past 15 years. From the register and network data it is difficult to tell how each of these measures is implemented in the participating hospitals, who provides medical treatment to patients when, and how medical care is organized in detail. This is why a survey on medical care for polytrauma and in mass casualty situations was conducted among medical directors in German surgical hospitals who are members of the German Society for Trauma Surgery (DGU). Thanks to the 211 participants (most of whom specialize in orthopedic and trauma surgery) a detailed description of how medical treatment is currently organized and performed could be acquired. The survey showed that care of patients with polytrauma (i.e. medical treatment and management) is important irrespective of the level of training of physicians and of the level of patient treatment in hospitals. The central role of traumatologists was emphasized not only in terms of actual treatment but also as an administrator for organizational and management matters. Almost all hospitals have plans for a mass casualty situation; however, the levels of preparedness show considerable variation. A highly critical view is taken of the new surgical specialists with respect to interdisciplinary and comprehensive emergency medical treatment

  3. The "RTR" medical response system for nuclear and radiological mass-casualty incidents: a functional TRiage-TReatment-TRansport medical response model.

    Science.gov (United States)

    Hrdina, Chad M; Coleman, C Norman; Bogucki, Sandy; Bader, Judith L; Hayhurst, Robert E; Forsha, Joseph D; Marcozzi, David; Yeskey, Kevin; Knebel, Ann R

    2009-01-01

    Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IND) or large radiological dispersal device (RDD) requires unique advanced planning due to the potential magnitude of the event, lack of warning, and radiation hazards. In order for medical care and resources to be collocated and matched to the requirements, a [US] Federal interagency medical response-planning group has developed a conceptual approach for responding to such nuclear and radiological incidents. The "RTR" system (comprising Radiation-specific TRiage, TReatment, TRansport sites) is designed to support medical care following a nuclear incident. Its purpose is to characterize, organize, and efficiently deploy appropriate materiel and personnel assets as close as physically possible to various categories of victims while preserving the safety of responders. The RTR system is not a medical triage system for individual patients. After an incident is characterized and safe perimeters are established, RTR sites should be determined in real-time that are based on the extent of destruction, environmental factors, residual radiation, available infrastructure, and transportation routes. Such RTR sites are divided into three types depending on their physical/situational relationship to the incident. The RTR1 sites are near the epicenter with residual radiation and include victims with blast injuries and other major traumatic injuries including radiation exposure; RTR2 sites are situated in relationship to the plume with varying amounts of residual radiation present, with most victims being ambulatory; and RTR3 sites are collection and transport sites with minimal or no radiation present or exposure risk and a victim population with a potential variety of injuries or radiation exposures. Medical Care sites are predetermined sites at which definitive medical care is given to those in immediate need of care. They include local/regional hospitals, medical centers, other

  4. 78 FR 38878 - Critical Incident Stress Plans

    Science.gov (United States)

    2013-06-28

    ... implement critical incident stress plans. As discussed in detail below, FRA reviewed the applicable science... productivity: Two reasons employee assistance programs make good business cents. Annals of the American... should be handled by each railroad on an individual basis, as the applicable science does not appear...

  5. Managing mass casualties and decontamination.

    Science.gov (United States)

    Chilcott, Robert P

    2014-11-01

    Careful planning and regular exercising of capabilities is the key to implementing an effective response following the release of hazardous materials, although ad hoc changes may be inevitable. Critical actions which require immediate implementation at an incident are evacuation, followed by disrobing (removal of clothes) and decontamination. The latter can be achieved through bespoke response facilities or various interim methods which may utilise water or readily available (dry, absorbent) materials. Following transfer to a safe holding area, each casualty's personal details should be recorded to facilitate a health surveillance programme, should it become apparent that the original contaminant has chronic health effects.

  6. Guidelines for Mass Casualty Decontamination During a HAZMAT/Weapon of Mass Destruction Incident. Volumes 1 and 2 (Update)

    Science.gov (United States)

    2013-08-01

    Waste Operations and Emer- gency Response). Establishing Zones In addition to the safety assessment, the First Responder should gain control of the...consistent with wind patterns or ventilation. Blisters / rashes Numerous individuals experiencing unex- plained blisters , bee sting like weals, and/ or...2013 Although the variations for setting up mass casualty decontamination systems are virtu- ally limitless, many waste precious minutes to set up

  7. Methods of Vessel Casualty Process Assessment

    Directory of Open Access Journals (Sweden)

    Jaroslaw Soliwoda

    2014-06-01

    Full Text Available Maritime casualty is an event of considerable economic and social impact. For this reason, implemented the reporting systems of accidents at sea, and the Administration was obligated to establish a Commission of Maritime Accidents. On the basis of casualty analysis and reports are developed proposals preventing similar casualties in the future. However, there is no uniform evaluation system which check references of existing regulations and recommendations to the occurred casualties. This paper presents a method to evaluate the used methods of casualty prediction with respect to the real incident and catastrophe.

  8. Decontamination of mass casualties--re-evaluating existing dogma.

    Science.gov (United States)

    Levitin, Howard W; Siegelson, Henry J; Dickinson, Stanley; Halpern, Pinchas; Haraguchi, Yoshikura; Nocera, Anthony; Turineck, David

    2003-01-01

    The events of 11 September 2001 became the catalyst for many to shift their disaster preparedness efforts towards mass-casualty incidents. Emergency responders, healthcare workers, emergency managers, and public health officials worldwide are being tasked to improve their readiness by acquiring equipment, providing training and implementing policy, especially in the area of mass-casualty decontamination. Accomplishing each of these tasks requires good information, which is lacking. Management of the incident scene and the approach to victim care varies throughout the world and is based more on dogma than scientific data. In order to plan effectively for and to manage a chemical, mass-casualty event, we must critically assess the criteria upon which we base our response. This paper reviews current standards surrounding the response to a release of hazardous materials that results in massive numbers of exposed human survivors. In addition, a significant effort is made to prepare an international perspective on this response. Preparations for the 24-hour threat of exposure of a community to hazardous material are a community responsibility for first-responders and the hospital. Preparations for a mass-casualty event related to a terrorist attack are a governmental responsibility. Reshaping response protocols and decontamination needs on the differences between vapor and liquid chemical threats can enable local responders to effectively manage a chemical attack resulting in mass casualties. Ensuring that hospitals have adequate resources and training to mount an effective decontamination response in a rapid manner is essential.

  9. Preparing South Carolina Emergency Departments for Mass Casualties with an Emphasis on the Planning Process

    Science.gov (United States)

    2013-03-01

    Kentucky University , 1988 B.S., University of Wisconsin-Stout, 1987 Submitted in partial fulfillment of the requirements for the degree of...need for an alternate care site (ACS) or off-site location is needed. These plans include the doubling of patients/room, using cafeterias , hallways

  10. Mass Casualty Decontamination in the United States: An Online Survey of Current Practice.

    Science.gov (United States)

    Power, Sarah; Symons, Charles; Carter, Holly; Jones, Emma; Amlôt, Richard; Larner, Joanne; Matar, Hazem; Chilcott, Robert P

    2016-01-01

    Mass casualty decontamination is a public health intervention that would be employed by emergency responders following a chemical, biological, or radiological incident. The decontamination of large numbers of casualties is currently most often performed with water to remove contaminants from the skin surface. An online survey was conducted to explore US fire departments' decontamination practices and their preparedness for responding to incidents involving mass casualty decontamination. Survey respondents were asked to provide details of various aspects of their decontamination procedures, including expected response times to reach casualties, disrobing procedures, approaches to decontamination, characteristics of the decontamination showering process, provision for special populations, and any actions taken following decontamination. The aim of the survey was to identify any differences in the way in which decontamination guidance is implemented across US states. Results revealed that, in line with current guidance, many US fire departments routinely use the "ladder-pipe system" for conducting rapid, gross decontamination of casualties. The survey revealed significant variability in ladder-pipe construction, such as the position and number of fire hoses used. There was also variability in decontamination characteristics, such as water temperature and water pressure, detergent use, and shower duration. The results presented here provide important insights into the ways in which implementation of decontamination guidance can vary between US states. These inconsistencies are thought to reflect established perceived best practices and local adaptation of response plans to address practical and logistical constraints. These outcomes highlight the need for evidence-based national guidelines for conducting mass casualty decontamination.

  11. Regional coordination in medical emergencies and major incidents; plan, execute and teach

    Directory of Open Access Journals (Sweden)

    Hedelin Annika

    2009-07-01

    Full Text Available Abstract Background Although disasters and major incidents are difficult to predict, the results can be mitigated through planning, training and coordinated management of available resources. Following a fire in a disco in Gothenburg, causing 63 deaths and over 200 casualties, a medical disaster response centre was created. The center was given the task to coordinate risk assessments, disaster planning and training of staff within the region and on an executive level, to be the point of contact (POC with authority to act as "gold control," i.e. to take immediate strategic command over all medical resources within the region if needed. The aim of this study was to find out if the centre had achieved its tasks by analyzing its activities. Methods All details concerning alerts of the regional POC was entered a web-based log by the duty officer. The data registered in this database was analyzed during a 3-year period. Results There was an increase in number of alerts between 2006 and 2008, which resulted in 6293 activities including risk assessments and 4473 contacts with major institutions or key persons to coordinate or initiate actions. Eighty five percent of the missions were completed within 24 h. Twenty eight exercises were performed of which 4 lasted more than 24 h. The centre also offered 145 courses in disaster and emergency medicine and crisis communication. Conclusion The data presented in this study indicates that the center had achieved its primary tasks. Such regional organization with executive, planning, teaching and training responsibilities offers possibilities for planning, teaching and training disaster medicine by giving immediate feed-back based on real incidents.

  12. Human casualties in earthquakes: modelling and mitigation

    Science.gov (United States)

    Spence, R.J.S.; So, E.K.M.

    2011-01-01

    Earthquake risk modelling is needed for the planning of post-event emergency operations, for the development of insurance schemes, for the planning of mitigation measures in the existing building stock, and for the development of appropriate building regulations; in all of these applications estimates of casualty numbers are essential. But there are many questions about casualty estimation which are still poorly understood. These questions relate to the causes and nature of the injuries and deaths, and the extent to which they can be quantified. This paper looks at the evidence on these questions from recent studies. It then reviews casualty estimation models available, and finally compares the performance of some casualty models in making rapid post-event casualty estimates in recent earthquakes.

  13. The influence of the pre-hospital application of non-invasive measurements of carboxyhemoglobin in the practice of emergency medical services in multiple and mass casualty incidents (MCI – A case report

    Directory of Open Access Journals (Sweden)

    Robert Gałązkowski

    2014-04-01

    Full Text Available In 2013 a fire broke out in the Nursing Home (NH in the Henryszew village 5 km away from the district hospital in Żyrardów. At the time of the incident 52 residents and 16 staff members were present in the building. Due to a large number of casualties, the occurrence was classified as a potentially mass casualty incident (MCI. Troops of the State Fire Brigade, Paramedic Rescue Squads, choppers of the Helicopter Emergency Medical Service, the Police, and the NH staff took part in the rescue operation. The priority was given to the evacuation of the NH residents carried out by the NH staff and firefighters, extinguishing the fire, as well as to primary and secondary survey triage. Due to the pre-accident health state of the victims, the latter posed a considerable difficulty. A decisive role was played by the need to conduct non-invasive measurements of carboxyhemoglobin in all the casualties, which then made it possible to adequately diagnose the patients and implement proper procedures. The rescue operation was correctly followed although it proved to be a serious logistical and technical undertaking for the participating emergency services. The residents were not found to be suffering from carbon monoxide poisoning, therefore 46 of the residents safely returned to the building. The fact that all the Paramedic Rescue Squads were equipped with medical triage sets and were able to conduct non-invasive measurements of carboxyhemoglobin made it possible to introduce effective procedures in the cases of suspected carbon monoxide poisoning and abandon costly and complicated organisational procedures when they proved to be unnecessary. Med Pr 2014;65(2:289–295

  14. Triage performance of Swedish physicians using the ATLS algorithm in a simulated mass casualty incident : a prospective cross-sectional survey

    OpenAIRE

    2013-01-01

    Background: In a mass casualty situation, medical personnel must rapidly assess and prioritize patients for treatment and transport. Triage is an important tool for medical management in disaster situations. Lack of common international and Swedish triage guidelines could lead to confusion. Attending the Advanced Trauma Life Support (ATLS) provider course is becoming compulsory in the northern part of Europe. The aim of the ATLS guidelines is provision of effective management of single critic...

  15. Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK’s Initial Operational Response (IOR)

    Science.gov (United States)

    Kassouf, Nick; Syed, Sara; Larner, Joanne; Amlôt, Richard

    2017-01-01

    The UK’s Initial Operational Response (IOR) is a revised process for the medical management of mass casualties potentially contaminated with hazardous materials. A critical element of the IOR is the introduction of immediate, on-scene disrobing and decontamination of casualties to limit the adverse health effects of exposure. Ad hoc cleansing of the skin with dry absorbent materials has previously been identified as a potential means of facilitating emergency decontamination. The purpose of this study was to evaluate the in vitro oil and water absorbency of a range of materials commonly found in the domestic and clinical environments and to determine the effectiveness of a small, but representative selection of such materials in skin decontamination, using an established ex vivo model. Five contaminants were used in the study: methyl salicylate, parathion, diethyl malonate, phorate and potassium cyanide. In vitro measurements of water and oil absorbency did not correlate with ex vivo measurements of skin decontamination. When measured ex vivo, dry decontamination was consistently more effective than a standard wet decontamination method (“rinse-wipe-rinse”) for removing liquid contaminants. However, dry decontamination was ineffective against particulate contamination. Collectively, these data confirm that absorbent materials such as wound dressings and tissue paper provide an effective, generic capability for emergency removal of liquid contaminants from the skin surface, but that wet decontamination should be used for non-liquid contaminants. PMID:28152053

  16. Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK's Initial Operational Response (IOR).

    Science.gov (United States)

    Kassouf, Nick; Syed, Sara; Larner, Joanne; Amlôt, Richard; Chilcott, Robert P

    2017-01-01

    The UK's Initial Operational Response (IOR) is a revised process for the medical management of mass casualties potentially contaminated with hazardous materials. A critical element of the IOR is the introduction of immediate, on-scene disrobing and decontamination of casualties to limit the adverse health effects of exposure. Ad hoc cleansing of the skin with dry absorbent materials has previously been identified as a potential means of facilitating emergency decontamination. The purpose of this study was to evaluate the in vitro oil and water absorbency of a range of materials commonly found in the domestic and clinical environments and to determine the effectiveness of a small, but representative selection of such materials in skin decontamination, using an established ex vivo model. Five contaminants were used in the study: methyl salicylate, parathion, diethyl malonate, phorate and potassium cyanide. In vitro measurements of water and oil absorbency did not correlate with ex vivo measurements of skin decontamination. When measured ex vivo, dry decontamination was consistently more effective than a standard wet decontamination method ("rinse-wipe-rinse") for removing liquid contaminants. However, dry decontamination was ineffective against particulate contamination. Collectively, these data confirm that absorbent materials such as wound dressings and tissue paper provide an effective, generic capability for emergency removal of liquid contaminants from the skin surface, but that wet decontamination should be used for non-liquid contaminants.

  17. A pan-European study of capabilities to manage mass casualties from the release of chemical agents: the MASH project.

    Science.gov (United States)

    Baker, David J; Murray, Virginia S G; Carli, Pierre A

    2013-01-01

    The European Union (EU) Mass Casualties and Health (MASH) project that ran between 2008 and 2010 was designed to study the management of mass casualties from chemical and radiological releases and associated health implications. One area of study for this project concerned arrangements within EU Member States for the management of mass casualties following a chemical release. This was undertaken via a confidential online questionnaire that was sent to selected points of contact throughout the EU. Responses were obtained from 18 states from respondents holding senior positions in chemical planning and incident response. Information gathered shows a lack of uniformity within the EU about the organization of responses to chemical releases and the provision of medical care. This article presents the overall findings of the study demonstrating differences between countries on planning and organization, decontamination, prehospital emergency medical responses, clinical diagnoses, and therapy and aftercare. Although there may be an understandable reluctance from national respondents to share information on security and other grounds, the findings, nevertheless, revealed substantial differences between current planning and operational responses within the EU states for the management of mass chemical casualties. The existing international networks for response to radiation incidents are not yet matched by equivalent networks for chemical responses yet sufficient information was available from the study to identify potential deficiencies, identify common casualty management pathways, and to make recommendations for future operations within the EU. Improvements in awareness and training and the application of modern information and communications will help to remedy this situation. Specialized advanced life support and other medical care for chemical casualties appear lacking in some countries. A program of specialized training and action are required to apply the findings

  18. Qualitative Analysis of Surveyed Emergency Responders and the Identified Factors That Affect First Stage of Primary Triage Decision-Making of Mass Casualty Incidents

    Science.gov (United States)

    Klein, Kelly R.; Burkle Jr., Frederick M.; Swienton, Raymond; King, Richard V.; Lehman, Thomas; North, Carol S.

    2016-01-01

    Introduction: After all large-scale disasters multiple papers are published describing the shortcomings of the triage methods utilized. This paper uses medical provider input to help describe attributes and patient characteristics that impact triage decisions. Methods: A survey distributed electronically to medical providers with and without disaster experience. Questions asked included what disaster experiences they had, and to rank six attributes in order of importance regarding triage. Results: 403 unique completed surveys were analyzed. 92% practiced a structural triage approach with the rest reporting they used “gestalt”.(gut feeling) Twelve per cent were identified as having placed patients in an expectant category during triage. Respiratory status, ability to speak, perfusion/pulse were all ranked in the top three. Gut feeling regardless of statistical analysis was fourth. Supplies were ranked in the top four when analyzed for those who had placed patients in the expectant category. Conclusion: Primary triage decisions in a mass casualty scenario are multifactorial and encompass patient mobility, life saving interventions, situational instincts, and logistics. PMID:27651979

  19. Incident Response Plan for a Small to Medium Sized Hospital

    Directory of Open Access Journals (Sweden)

    Charles DeVoe

    2013-04-01

    Full Text Available Most small to medium health care organizations do not have the capability to address cyber incidents within the organization.Those that do are poorly trained and ill equipped .These health care organizations are subject to various laws that address privacy concerns , proper handling of financial information, and Person ally Identifiable Information. Currently an IT staff handles responses to these incidents in an Ad Hoc manner.A properly trained, staffed,and equipped Cyber Incident Response Team is needed to quickly respond to these incidents to minimize data loss, and provide forensic data for the purpose of notification, disciplinary action, legal action, and to remove the risk vector. This paper 1 will use the proven Incident Command System model used in emergency services to show any sized agency can have an a dequate CIRT.

  20. Tsunami Casualty Model

    Science.gov (United States)

    Yeh, H.

    2007-12-01

    More than 4500 deaths by tsunamis were recorded in the decade of 1990. For example, the 1992 Flores Tsunami in Indonesia took away at least 1712 lives, and more than 2182 people were victimized by the 1998 Papua New Guinea Tsunami. Such staggering death toll has been totally overshadowed by the 2004 Indian Ocean Tsunami that claimed more than 220,000 lives. Unlike hurricanes that are often evaluated by economic losses, death count is the primary measure for tsunami hazard. It is partly because tsunamis kill more people owing to its short lead- time for warning. Although exact death tallies are not available for most of the tsunami events, there exist gender and age discriminations in tsunami casualties. Significant gender difference in the victims of the 2004 Indian Ocean Tsunami was attributed to women's social norms and role behavior, as well as cultural bias toward women's inability to swim. Here we develop a rational casualty model based on humans' limit to withstand the tsunami flows. The application to simple tsunami runup cases demonstrates that biological and physiological disadvantages also make a significant difference in casualty rate. It further demonstrates that the gender and age discriminations in casualties become most pronounced when tsunami is marginally strong and the difference tends to diminish as tsunami strength increases.

  1. Key Planning Factors for Recovery from a Biological Terrorism Incident

    Science.gov (United States)

    2012-08-30

    goals may be advised for areas where young children or people with compromised immune systems spend considerable time. Pre-planning for clearance...Cipro) can cause moderate to severe nausea, diarrhea , vomiting, headache, stomach pain, skin rashes, mental confusion, tremors, seizures

  2. Effect of Hospital Staff Surge Capacity on Preparedness for a Conventional Mass Casualty Event

    Directory of Open Access Journals (Sweden)

    Welzel, Tyson B MD

    2010-05-01

    Full Text Available OBJECTIVES: To assess current medical staffing levels within the Hospital Referral System in the City of Cape Town Metropolitan Municipality, South Africa, and analyze the surge capacity needs to prepare for the potential of a conventional mass casualty incident during a planned mass gathering.METHODS: Query of all available medical databases of both state employees and private medical personnel within the greater Cape Town area to determine current staffing levels and distribution of personnel across public and private domains. Analysis of the adequacy of available staff to manage a mass casualty incident.RESULTS: There are 594 advanced pre-hospital personnel in Cape Town (17/100,000 population and 142 basic pre-hospital personnel (4.6/100,000. The total number of hospital and clinic-based medical practitioners is 3097 (88.6/100,000, consisting of 1914 general physicians; 54.7/100,000 and 1183 specialist physicians; 33.8/100,000. Vacancy rates for all medical practitioners range from 23.5% to 25.5%. This includes: nursing post vacancies (26%, basic emergency care practitioners (39.3%, advanced emergency care personnel (66.8%, pharmacy assistants (42.6%, and pharmacists (33.1%.CONCLUSION: There are sufficient numbers and types of personnel to provide the expected ordinary healthcare needs at mass gathering sites in Cape Town; however, qualified staff are likely insufficient to manage a concurrent mass casualty event. Considering that adequate correctly skilled and trained staff form the backbone of disaster surge capacity, it appears that Cape Town is currently under resourced to manage a mass casualty event. With the increasing size and frequency of mass gathering events worldwide, adequate disaster surge capacity is an issue of global relevance. [West J Emerg Med. 2010; 11(2:189-196.

  3. 76 FR 42124 - Availability of the Incident Waste Management Planning and Response Tool

    Science.gov (United States)

    2011-07-18

    ... AGENCY Availability of the Incident Waste Management Planning and Response Tool AGENCY: Environmental... Waste Management Planning and Response Tool ``IWMPRT'' was developed partly to satisfy requirements... upcoming meeting where the public will be invited to attend and comment on the IWMPRT. The tool...

  4. Key Planning Factors for Recovery from a Radiological Terrorism Incident

    Science.gov (United States)

    2012-09-01

    Livermore National Laboratory – Annmarie R. Wood- Zika , Lawrence Livermore National Laboratory – Robert P. Fischer, Lawrence Livermore National...recovery timeline and costs , improving public health and safety, and addressing major resource limitations and critical decisions. DHS S&T would like to...time, recovery costs , and improve public health and safety. Key Planning Factors described in these documents will help local, state, and Federal

  5. An Alternative Health Care Facility: Concept of Operations for the Off-site Triage, Treatment, and Transportation Center (OST3C). Mass Casualty Care Strategy for a Chemical Terrorism Incident

    Science.gov (United States)

    2001-03-01

    develop non- cardiogenic pulmonary edema within 6 hours after exposure to a “choking” agent such as phosgene. These patients should be transported to a...admitted for observation, as they may develop pulmonary edema . E. Psychological Casualties Disasters have a tremendous emotional and psychological

  6. Model uniform core criteria for mass casualty triage.

    Science.gov (United States)

    2011-06-01

    There is a need for model uniform core criteria for mass casualty triage because disasters frequently cross jurisdictional lines and involve responders from multiple agencies who may be using different triage tools. These criteria (Tables 1-4) reflect the available science, but it is acknowledged that there are significant research gaps. When no science was available, decisions were formed by expert consensus derived from the available triage systems. The intent is to ensure that providers at a mass-casualty incident use triage methodologies that incorporate these core principles in an effort to promote interoperability and standardization. At a minimum, each triage system must incorporate the criteria that are listed below. Mass casualty triage systems in use can be modified using these criteria to ensure interoperability. The criteria include general considerations, global sorting, lifesaving interventions, and assignment of triage categories. The criteria apply only to providers who are organizing multiple victims in a discrete geographic location or locations, regardless of the size of the incident. They are classified by whether they were derived through available direct scientific evidence, indirect scientific evidence, expert consensus, and/or are used in multiple existing triage systems. These criteria address only primary triage and do not consider secondary triage. For the purposes of this document the term triage refers to mass-casualty triage and provider refers to any person who assigns primary triage categories to victims of a mass-casualty incident.

  7. Incidence and prevalence of acromegaly in a large US health plan database

    OpenAIRE

    Burton, Tanya; Le Nestour, Elisabeth; Neary, Maureen; Ludlam, William H.

    2016-01-01

    Purpose Incidence and prevalence estimates of acromegaly in the United States (US) are limited. Most existing reports are based on European data sources. The objective of this study was to estimate the annual incidence and prevalence of acromegaly in a large US managed care population, overall and stratified by age, sex, and geographic region, using data from 2008 to 2012. Methods Using administrative claims data, commercial health plan enrollees were identified with acromegaly if they had tw...

  8. 城市成批伤亡事件医院救护模式的回顾性研究%A retrospective study of hospital response model to urban mass casualty incidents

    Institute of Scientific and Technical Information of China (English)

    桂莉; 张宝胜; 张静; 厉瑛; 陈瑶; 周玲君; 席淑华

    2011-01-01

    目的 介绍上海"11.15"特大火灾成批伤员医院内救护模式,分析本模式在城市成批伤救护中的运用效果.方法 回顾性调查承担主要救治任务的某二级甲等医院的医护人负共5名,采用查看病历、问卷调查和半结构访谈等方法,获取医院及伤员基本资料、院内救护展开模式、伤员转归及医护人员评价.结果:该院共接收56例伤员,以吸入性损伤为主.医院采用的是"以急诊科为主组织院内抢救,院领导协调救护资源调配"的救护模式,以及"病房作为急诊的大后方,二三级医院联合救助"的伤员分流模式.伤员预后良好,救护人员整体评价好.结论:本次医院所采取的医院内外协作救护模式值得借鉴,但还需加强应急分队和制度建设、优化流程等措施,以提高医院对于成批伤的救护能力.%Objective To introduce the hospital responae model to the victims of 2010 Shanghai fire and analyze the effectiveness of this model in coping with urban mass casualty incidents (MCI). Methods A retrospective study was conducted by record review,questionnaire investigation and semi-structure interview in five medical staff who took part in the rescue. Data were collected on the general information of the hospital and the victims,hospital response model,prognosis of the victims and appraisal of medical staff. Results Fifty-six victims were sent to the hospital ,most of whom suffered from inhalation injuries.By establishing the green channel in emergency department,deploying rescue resources by the leader,and cooperation among second-class hospital and irst-class hospitals,the hospital responsed to the incident effectively. For most victims,their prognosis was quite good. Conclusion The hospital response model to the fire rescue had successful experiences to follow,and the urban hospitals' capacity should be further enhanced by organizing and training rapid reponse team and updating the protocol.

  9. Public experiences of mass casualty decontamination.

    Science.gov (United States)

    Carter, Holly; Drury, John; Rubin, G James; Williams, Richard; Amlôt, Richard

    2012-09-01

    In this article, we analyze feedback from simulated casualties who took part in field exercises involving mass decontamination, to gain an understanding of how responder communication can affect people's experiences of and compliance with decontamination. We analyzed questionnaire data gathered from 402 volunteers using the framework approach, to provide an insight into the public's experiences of decontamination and how these experiences are shaped by the actions of emergency responders. Factors that affected casualties' experiences of the decontamination process included the need for greater practical information and better communication from responders, and the need for privacy. Results support previous findings from small-scale incidents that involved decontamination in showing that participants wanted better communication from responders during the process of decontamination, including more practical information, and that the failure of responders to communicate effectively with members of the public led to anxiety about the decontamination process. The similarity between the findings from the exercises described in this article and previous research into real incidents involving decontamination suggests that field exercises provide a useful way to examine the effect of responder communication strategies on the public's experiences of decontamination. Future exercises should examine in more detail the effect of various communication strategies on the public's experiences of decontamination. This will facilitate the development of evidence-based communication strategies intended to reduce anxiety about decontamination and increase compliance among members of the public during real-life incidents that involve mass decontamination.

  10. Field assessment of a model tuberculosis outbreak response plan for low-incidence areas

    Directory of Open Access Journals (Sweden)

    Pascopella Lisa

    2007-10-01

    Full Text Available Abstract Background For a regional project in four low-incidence states, we designed a customizable tuberculosis outbreak response plan. Prior to dissemination of the plan, a tuberculosis outbreak occurred, presenting an opportunity to perform a field assessment of the plan. The purpose of the assessment was to ensure that the plan included essential elements to help public health professionals recognize and respond to outbreaks. Methods We designed a semi-structured questionnaire and interviewed all key stakeholders involved in the response. We used common themes to assess validity of and identify gaps in the plan. A subset of participants provided structured feedback on the plan. Results We interviewed 11 public health and six community stakeholders. The assessment demonstrated that (1 almost all of the main response activities were reflected in the plan; (2 the plan added value by providing a definition of a tuberculosis outbreak and guidelines for communication and evaluation. These were areas that lacked written protocols during the actual outbreak response; and (3 basic education about tuberculosis and the interpretation and use of genotyping data were important needs. Stakeholders also suggested adding to the plan questions for evaluation and a section for specific steps to take when an outbreak is suspected. Conclusion An interactive field assessment of a programmatic tool revealed the value of a systematic outbreak response plan with a standard definition of a tuberculosis outbreak, guidelines for communication and evaluation, and response steps. The assessment highlighted the importance of education and training for tuberculosis in low-incidence areas.

  11. Truth hurts--hard lessons from Australia's largest mass casualty exercise with contaminated patients.

    Science.gov (United States)

    Edwards, Nicholas A; Caldicott, David G E; Eliseo, Tony; Pearce, Andrew

    2006-04-01

    In response to the increasing threat of a mass casualty incident involving chemical, biological or radiological agents, and concern over the preparedness of our hospital system to cope with patients from such an incident, we conducted the largest hospital-based field exercise involving contaminated patients that has been held in Australia. In the present paper, we outline the background to, and methodology of, Exercise Supreme Truth, and the efforts made to increase its realism. We focus our discussion on three issues highlighted by the exercise, which we believe have enormous implications for the development of hospital chemical, biological or radiological plans and the likelihood of their success--hospital security, crowd control and decontamination.

  12. Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil.

    Science.gov (United States)

    Dal Ponte, Silvana T; Dornelles, Carlos F D; Arquilla, Bonnie; Bloem, Christina; Roblin, Patricia

    2015-02-01

    On January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.

  13. Development and organization for casualty management on a 1,000-bed hospital ship in the Persian Gulf.

    Science.gov (United States)

    Ochsner, M G; Harviel, J D; Stafford, P W; Blankenship, C; Bosse, M J; Timberlake, G A; McSwain, N E

    1992-04-01

    A 1,000-bed hospital ship designed for trauma patients was deployed to the Middle East with the objectives of preparing for large numbers of casualties resulting from Operation Desert Storm from conventional, chemical, and biological weapons. Plans for receipt and decontamination of casualties, triage, and optimal utilization of the 1,000-bed facility were developed. Mass casualty drills were conducted, involving all aspects of patient care from the flight deck to the wards. Trauma and critical care registries were developed to collect casualty data that could then be analyzed for specific military purposes and compared with current civilian registries. Attempts were made to identify the advances in shock resuscitation, systems management, and operative treatment from the civilian community that could be applied to care of combat casualties. Difficulties with accomplishing these objectives included limited trauma experience and supplies and poorly defined medical regulating and evacuation policies. The development of these programs, as well as the unique difficulties encountered, are discussed.

  14. Application of Real-Time Automated Traffic Incident Response Plan Management System: A Web Structure for the Regional Highway Network in China

    Directory of Open Access Journals (Sweden)

    Yongfeng Ma

    2014-01-01

    Full Text Available Traffic incidents, caused by various factors, may lead to heavy traffic delay and be harmful to traffic capacity of downstream sections. Traffic incident management (TIM systems have been developed widely to respond to traffic incidents intelligently and reduce the losses. Traffic incident response plans, as an important component of TIM, can effectively guide responders as to what and how to do in traffic incidents. In the paper, a real-time automated traffic incident response plan management system was developed, which could generate and manage traffic incident response plans timely and automatically. A web application structure and a physical structure were designed to implement and show these functions. A standard framework of data storage was also developed to save information about traffic incidents and generated response plans. Furthermore, a conformation survey and case-based reasoning (CBR were introduced to identify traffic incident and generate traffic incident response plans automatically, respectively. Twenty-three traffic crash-related incidents were selected and three indicators were used to measure the system performance. Results showed that 20 of 23 cases could be retrieved effectively and accurately. The system is practicable to generate traffic incident response plans and has been implemented in China.

  15. Deterring Mass-Casualty Terrorism

    Science.gov (United States)

    2002-01-01

    om pa ny (T ho m as B ra y) Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting...actions that could create mass casualties or specific types of attack? Should the ob- jective be preventing conflict escala - tion over a determined...E G LO B A L W A R O N T E R R O R IS M Simulated attack, Foggy Shores 02–06. 30 th C om m un ic at io ns S qu ad ro n (J en ni fe r C . W

  16. 33 CFR 146.40 - Diving casualties.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Diving casualties. 146.40 Section 146.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.40 Diving casualties. Diving related...

  17. 46 CFR 4.03-1 - Marine casualty or accident.

    Science.gov (United States)

    2010-10-01

    ... States vessel wherever such casualty or accident occurs; or (3) With respect to a foreign tank vessel... 46 Shipping 1 2010-10-01 2010-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1... AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  18. Fires in rooms containing electrical components - incident planning, fire fighting tactics, risks; Braender i driftrum - Insatsplaner, slaeckteknik, risker

    Energy Technology Data Exchange (ETDEWEB)

    Magnusson, Tommy; Ottosson, Jan; Lindskog, BertiI; Soederquist Bende, Evy; Eriksson, Fredrik; Haffling, Stefan

    2006-12-15

    On July 1, 2005 a fire occurred within an electrical switch room at Forsmark Nuclear Power Plant. At the evaluation of the incident it was identified that the pre-fire plans did not give sufficient information in order to make the appropriate decisions. Questions raised based on the incident are how decisions are made and orders are delegated with respect to the incident command, which fire fighting tactic should be used, which types of extinguishing media should be used, what are the risks with respect to safety of staff and safety of the reactor. Lessons learned from the fire at Forsmark were that pre-incident planning was at hand but the information was not sufficient to make the correct initial decisions that might be critical for life and property. One of the most crucial ingredients in all safety related work is to utilize previous experience in order to maintain a high degree of safety. Lessons learnt are also the foundation on which the ability to construct or create strong barriers against a certain fault phenomena, fault mechanism or type of initial event. In the case of nuclear processes, fire is considered as an important and critical initial event which has to be recognized in a number of cases in order to maintain a safe process. The likelihood for a fire to represent an initial event should not be underestimated and can therefore not be neglected, probabilistically or deterministically, unless the inherent safety systems can not control the event in an acceptable manner. Regardless of safety measures and lessons learnt from previous experiences in the construction and the operation of the nuclear facility, fires can occur. Previous experiences point out that process system, e.g. systems that are part of the turbine, are more frequently subject to fire incidents compared to ordinary safety systems. Fires in electrical components, often electrical cabinets, can be difficult to handle and to extinguish quickly. This report presents the background work

  19. Key Planning Factors for Recovery from a Chemical Warfare Agent Incident

    Science.gov (United States)

    2012-07-01

    chemical scenario involving the release of a blister agent (mustard lewisite) would result in a waste that the State of Colorado would regulate as... Waste Management ................................................................. 24 4.3 Key Planning Factors: Recovery Planning...Planning Factors, this document presents a chemical warfare agent scenario featuring Agent Yellow, a blister agent. Agent Yellow is a mixture of

  20. Evaluation of Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma

    Science.gov (United States)

    2016-02-01

    and en Route Care of Combat Casualties in a Swine Polytrauma PRINCIPAL INVESTIGATOR: Richard McCarron, PhD CONTRACTING ORGANIZATION: Henry M...Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma Award Number: W81XWH-13-2-0022, 3rd Annual Report JAN2016 3...models of neurotrauma and polytrauma . We plan to investigate the effects of aero-medical evacuation on neurophysiology and lung function in swine

  1. Medical management of toxicological mass casualty events.

    Science.gov (United States)

    Markel, Gal; Krivoy, Amir; Rotman, Eran; Schein, Ophir; Shrot, Shai; Brosh-Nissimov, Tal; Dushnitsky, Tsvika; Eisenkraft, Arik

    2008-11-01

    The relative accessibility to various chemical agents, including chemical warfare agents and toxic industrial compounds, places a toxicological mass casualty event, including chemical terrorism, among the major threats to homeland security. TMCE represents a medical and logistic challenge with potential hazardous exposure of first-response teams. In addition, TMCE poses substantial psychological and economic impact. We have created a simple response algorithm that provides practical guidelines for participating forces in TMCE. Emphasis is placed on the role of first responders, highlighting the importance of early recognition of the event as a TMCE, informing the command and control centers, and application of appropriate self-protection. The medical identification of the toxidrome is of utmost importance as it may dictate radically different approaches and life-saving modalities. Our proposed emergency management of TMCE values the "Scoop & Run" approach orchestrated by an organized evacuation plan rather than on-site decontamination. Finally, continuous preparedness of health systems - exemplified by periodic CBRN (Chemical, Biological, Radio-Nuclear) medical training of both first responders and hospital staff, mandatory placement of antidotal auto-injectors in all ambulances and CBRN emergency kits in the emergency departments - would considerably improve the emergency medical response to TMCE.

  2. An Integrated Civilian Medical Response to Mass Casualty Incidents

    Science.gov (United States)

    2005-05-01

    34Decontamination of bacillus thuringiensis spores on selected surfaces by chlorine dioxide gas", Journal of Environmental Health 66: 16-20 6. Jeng, D. K., and...impaction, because it minimizes desiccation stress and allows for the direct deposition of the microorganism into growth media. The AGI-30 liquid impinger...combines this data with the chemical kinetics of non-thermal plasma to predict the rate of destruction of microorganisms under varying conditions. The

  3. Recovery from a chemical weapons accident or incident: A concept paper on planning

    Energy Technology Data Exchange (ETDEWEB)

    Herzenberg, C.L.; Haffenden, R.; Lerner, K.; Meleski, S.A.; Tanzman, E.A. [Argonne National Lab., IL (United States); Lewis, L.M. [US Dept. of Agriculture (United States); Hemphill, R.C. [Niagara Mohawk Power Corporation (United States); Adams, J.D. [US Environmental Protection Agency (United States)

    1994-04-01

    Emergency planning for an unintended release of chemical agent from the nation`s chemical weapons stockpile should include preparation for. the period following implementation of immediate emergency response. That period -- the recovery, reentry, and restoration stage -- is the subject of this report. The report provides an overview of the role of recovery, reentry, and restoration planning in the Chemical Stockpile Emergency Preparedness Program (CSEPP), describes the transition from immediate emergency response to restoration, and analyzes the legal framework that would govern restoration activities. Social, economic, and administrative issues, as well as technical ones, need to be considered in the planning effort. Because of possible jurisdictional conflicts, appropriate federal, state, and local agencies need to be included in a coordinated planning process. Advance consideration should be given to the pertinent federal and state statutes and regulations. On the federal level, the principal statutes and regulations to be considered are those associated with the Comprehensive Environmental Response, Compensation, and Liability Act; the Resource Conservation and Recovery Act; and the National Environmental Policy Act. This report recommends that extensive preaccident planning be undertaken for the recovery, reentry, and restoration stage and outlines several key issues that should be considered in that planning. The need for interagency cooperation and coordination at all levels of the planning process is emphasized.

  4. Development of the science of mass casualty incident management:reflection on the medical response to the Wenchuan earthquake and Hangzhou bus fire%大规模伤亡事件应对研究范式的发展:基于汶川地震和杭州公交车起火事件紧急医疗救援的反思

    Institute of Scientific and Technical Information of China (English)

    Wei-feng SHEN; Li-bing JIANG; Guan-yu JIANG; Mao ZHANG; Yue-feng MA; Xiao-jun HE‡

    2014-01-01

    Objective: In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematicaly and reflect the medical response to the Wenchuan earthquake and Hangzhou bus fire, in order to outline and develop an improved research paradigm for MCI management. Methods: We searched PubMed, EMBASE, China Wanfang, and China Biology Medicine (CBM) databases for relevant studies. The folowing key words and medical subject headings were used: ‘mass casualty incident’, ‘MCI’, ‘research method’, ‘Wenchuan’, ‘earthquake’, ‘research paradigm’, ‘science of surge’, ‘surge’, ‘surge capacity’, and ‘vulnerability’. Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, 2008 Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors. Results: The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods (medical severity index (MSI), potential injury creating event (PICE) classification, and disaster severity scale (DSS)), which can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations. However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses. Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored—vulnerability, based on reflecting on the MCI response to the 2008 Wenchuan earthquake and July 5 bus fire in Hangzhou. Conclusions: This new paradigm breaks through the

  5. Surface Reflection Coefficient of Impregnated RAM Honeycomb with Incident Normally Plan Wave to the Side Wall

    Institute of Scientific and Technical Information of China (English)

    GAO Zhengping; LUO Qing

    2004-01-01

    The impregnated radar absorbing material(RAM) honeycomb is often used to fabricate parts of the warplane for reducing radar cross section.The incidentwave vector may be divided into two components:one perpendicular to its hole and the other to its side wall.Until now,there has not been a program to calculate the input impedance or its equivalent electromagnetic parameters for the later case.In this paper,an approach for analyzing the reflection characteristics of the impregnated honeycomb when its side wall faces the incident plane wave is proposed.Experiments prove it an effective,accurate and fast solution to this subject.

  6. Pushing up smoking incidence: plans for a privatised tobacco industry in Moldova.

    Science.gov (United States)

    Gilmore, Anna B; Radu-Loghin, Cornel; Zatushevski, Irina; McKee, Martin

    Moldova, one of the former Soviet republics and Europe's poorest country, has so far resisted pressure to privatise its tobacco industry. This paper examines the policies pursued by the transnational tobacco companies in Moldova in order to inform the ongoing debate about tobacco industry privatisation. We analysed relevant internal industry documents made public through litigation. The documents suggest that although a competitive tender for the state owned monopoly was later announced, British American Tobacco (BAT) and the German manufacturer Reemtsma each initially sought to secure a closed deal, with BAT accusing Reemtsma of underhand tactics. Imperial Tobacco, which now owns Reemstma, was unable to comment on these allegations as it only acquired Reemstma after the events in question. BAT sought to acquire a monopoly position, bolstered by excise rules developed by the company that would uniquely favour its products. Despite hoping to establish a monopoly, it planned intensive marketing, as if in a competitive market, aiming to target young urban dwellers, particularly opinion leaders. In so doing it predicted that smoking uptake would increase, especially among women. The documents also suggest that BAT was aware of the sensitive nature of its plans to cull the processing workforce and aimed to present "sanitised" information on future employment levels to the Moldovans. The potential for tobacco industry privatisation to undermine tobacco control and promote cigarette consumption is highlighted and is consistent with economic theory. Countries planning tobacco industry privatisation should ensure a transparent and competitive privatisation process, seek to prevent the predicted increase in consumption by implementing effective tobacco control policies and consider the impacts on employment. Multilateral financial organisations promoting tobacco industry privatisation could ensure their loan conditions protect public health by making the implementation of

  7. Prescribing of benzodiazepines by casualty officers.

    OpenAIRE

    1989-01-01

    The prescribing of benzodiazepines by casualty officers in a busy district hospital over a three month period was examined by a retrospective review of case notes. Benzodiazepines, mainly diazepam, were given to 1.1% of attenders, the majority of whom had disorders involving minor muscle spasm. The efficacy of diazepam in these conditions, as well as its potential for dependence, is discussed.

  8. Friendly Combat Casualties and Operational Narratives

    Science.gov (United States)

    2015-06-21

    struggling with maintaining its narrative in the face of a growing insurgency and sectarian violence .55 Throughout the early part of 2004 the situation...Friendly Combat Casualties and Operational Narratives A Monograph by Major Errol G. MacEachern Canadian Army...this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data

  9. The Casualty Network System Capstone Project

    Science.gov (United States)

    2012-12-01

    records information on the casualty’s injuries and the medic’s treatments via voice recognition. As the medic performs his primary survey he speaks into...providers and resources. The CNS has the potential to serve as an impromptu network in HADR settings to match providers, resources and casualties. Given

  10. Review of On-Scene Management of Mass-Casualty Attacks

    Directory of Open Access Journals (Sweden)

    Annelie Holgersson

    2016-02-01

    Full Text Available Background: The scene of a mass-casualty attack (MCA entails a crime scene, a hazardous space, and a great number of people needing medical assistance. Public transportation has been the target of such attacks and involves a high probability of generating mass casualties. The review aimed to investigate challenges for on-scene responses to MCAs and suggestions made to counter these challenges, with special attention given to attacks on public transportation and associated terminals. Methods: Articles were found through PubMed and Scopus, “relevant articles” as defined by the databases, and a manual search of references. Inclusion criteria were that the article referred to attack(s and/or a public transportation-related incident and issues concerning formal on-scene response. An appraisal of the articles’ scientific quality was conducted based on an evidence hierarchy model developed for the study. Results: One hundred and five articles were reviewed. Challenges for command and coordination on scene included establishing leadership, inter-agency collaboration, multiple incident sites, and logistics. Safety issues entailed knowledge and use of personal protective equipment, risk awareness and expectations, cordons, dynamic risk assessment, defensive versus offensive approaches, and joining forces. Communication concerns were equipment shortfalls, dialoguing, and providing information. Assessment problems were scene layout and interpreting environmental indicators as well as understanding setting-driven needs for specialist skills and resources. Triage and treatment difficulties included differing triage systems, directing casualties, uncommon injuries, field hospitals, level of care, providing psychological and pediatric care. Transportation hardships included scene access, distance to hospitals, and distribution of casualties. Conclusion: Commonly encountered challenges during unintentional incidents were added to during MCAs, implying

  11. Prophylaxis for blood-borne diseases during the London 7/7 mass casualty terrorist bombing: a review and the role of bioethics.

    Science.gov (United States)

    Edwards, Dafydd S; Barnett-Vanes, A; Narayan, N; Patel, H D L

    2016-10-01

    The suicide bombings in London on 7 July 2005 resulted in a mass casualty situation. Over 50% of casualties were treated at the Royal London Hospital where clinicians witnessed large numbers of severely injured patients. In some casualties human biological foreign material was found embedded in the soft tissue originating from the suicide bombers or other casualties. This had the potential of placing individuals at risk of transmission of blood-borne diseases. Advances in the fields of medicine and biology have led to increased survivorship in the context of trauma and mass casualty incidents. This has resulted in the emergence of ethical scenarios surrounding patient management. A systematic review of the literature of the 7/7 bombings, and suicide bombings reported globally, where biological implantation is noted, was performed to examine the medicolegal issues arising during such attack. Twelve casualties with human tissue implanted were recorded in the 7/7 bombings. While all patients at risk were given prophylaxis based on recommendations by the Health Protection Agency, several ethical considerations surfaced as a result. In this paper, we compare the sequence of events and the management process of the victims of the 7/7 bombings and the evidence-based research regarding blood-borne infection transmission. Furthermore, it explores the ethical dilemmas, experienced by the senior author on 7/7, surrounding prophylaxis for blood-borne diseases and protocols to avoid confusion over best practice in future bombing incidents.

  12. An Eye Oximeter for Combat Casualty Care

    Science.gov (United States)

    1999-01-01

    81 4 Introduction Exsanguination is the most immediate life threatening danger for the field casualty during wartime. Indeed, 60% of...intramuscular pre- anesthetic ketamine 600 mg and xylazine 100 mg. The swine were placed in the supine position, intubated endotracheally and placed on a...preanesthetic ketamine 600 mg and xylazine 100 mg. The swine were placed Study Protocol. The animal was exsanguinated in the supine position, intubated

  13. Decontamination of multiple casualties who are chemically contaminated: a challenge for acute hospitals.

    Science.gov (United States)

    Clarke, Simon F J; Chilcott, Rob P; Wilson, James C; Kamanyire, Robie; Baker, David J; Hallett, Anthony

    2008-01-01

    Patients who have been contaminated by chemical compounds present a number of difficulties to emergency departments, in particular, the risk of secondary contamination of healthcare staff and facilities. The Department of Health in the United Kingdom has provided equipment to decontaminate chemically contaminated casualties who present at emergency departments. The capacity of this equipment is limited, and although both the ambulance and fire services have equipment to cope with mass casualties at the scene of a chemical incident, there is still the possibility that acute hospitals will be overwhelmed by large numbers of self-presenting patients. The risks and potential consequences of this gap in resilience are discussed and a number of possible practical solutions are proposed.

  14. MiRTE: Mixed Reality Triage and Evacuation game for Mass Casualty information systems design, testing and training.

    Science.gov (United States)

    Yu, Xunyi; Ganz, Aura

    2011-01-01

    In this paper we introduce a Mixed Reality Triage and Evacuation game, MiRTE, that is used in the development, testing and training of Mass Casualty Incident (MCI) information systems for first responders. Using the Source game engine from Valve software, MiRTE creates immersive virtual environments to simulate various incident scenarios, and enables interactions between multiple players/first responders. What distinguishes it from a pure computer simulation game is that it can interface with external mass casualty incident management systems, such as DIORAMA. The game will enable system developers to specify technical requirements of underlying technology, and test different alternatives of design. After the information system hardware and software are completed, the game can simulate various algorithms such as localization technologies, and interface with an actual user interface on PCs and Smartphones. We implemented and tested the game with the DIORAMA system.

  15. The Casualty Actuarial Society: Helping Universities Train Future Actuaries

    Science.gov (United States)

    Boa, J. Michael; Gorvett, Rick

    2014-01-01

    The Casualty Actuarial Society (CAS) believes that the most effective way to advance the actuarial profession is to work in partnership with universities. The CAS stands ready to assist universities in creating or enhancing courses and curricula associated with property/casualty actuarial science. CAS resources for university actuarial science…

  16. 46 CFR 197.488 - Retention of records after casualty.

    Science.gov (United States)

    2010-10-01

    ... casualty is made under § 197.484 shall retain all records onboard that are maintained on the vessel or... until advised by the Officer-in-Charge, Marine Inspection, that records need not be retained onboard....

  17. Casualties, Public Opinion, and Presidential Policy during the Vietnam War.

    Science.gov (United States)

    1985-03-01

    of his charts, reproduced here as Fig. 6, plotted the rising casualty levels in Korea against the declin- ing public support for the Korean war. Ball...relationship between U.S. casualties and public support for U.S. military int-rvention in Korea and Vietnam, and concludeb that a strong inverse...Contingencies," investigated possible configurations for a firepower projection force to be employed in the defense of Third World allies. One of the

  18. A burn mass casualty event due to boiler room explosion on a cruise ship: preparedness and outcomes.

    Science.gov (United States)

    Tekin, Akin; Namias, Nicholas; O'Keeffe, Terence; Pizano, Louis; Lynn, Mauricio; Prater-Varas, Robin; Quintana, Olga Delia; Borges, Leda; Ishii, Mary; Lee, Seong; Lopez, Peter; Lessner-Eisenberg, Sharon; Alvarez, Angel; Ellison, Tom; Sapnas, Katherine; Lefton, Jennifer; Ward, Charles Gillon

    2005-03-01

    The purpose of this study was to review our experience with a mass casualty incident resulting from a boiler room steam explosion aboard a cruise ship. Experience with major, moderate, and minor burns, steam inhalation, mass casualty response systems, and psychological sequelae will be discussed. Fifteen cruise ship employees were brought to the burn center after a boiler room explosion on a cruise ship. Eleven were triaged to the trauma resuscitation area and four to the surgical emergency room. Seven patients were intubated for respiratory distress or airway protection. Six patients had >80 per cent burns with steam inhalation, and all of these died. One of the 6 patients had 99 per cent burns with steam inhalation and died after withdrawal of support within the first several hours. All patients with major burns required escharotomy on arrival to trauma resuscitation. One patient died in the operating room, despite decompression by laparotomy for abdominal compartment syndrome and pericardiotomy via thoracotomy for cardiac tamponade. Four patients required crystalloid, 20,000 mls/m2-27,000 ml/m2 body surface area (BSA) in the first 48 hours to maintain blood pressure and urine output. Three of these four patients subsequently developed abdominal compartment syndrome and died in the first few days. The fourth patient of this group died after 26 days due to sepsis. Five patients had 13-20 per cent bums and four patients had less than 10 per cent burns. Two of the patients with 20 per cent burns developed edema of the vocal cords with mild hoarseness. They improved and recovered without intubation. The facility was prepared for the mass casualty event; having just completed a mass casualty drill several days earlier. Twenty-six beds were made available in 50 minutes for anticipated casualties. Fifteen physicians reported immediately to the trauma resuscitation area to assist in initial stabilization. The event occurred at shift change; thus, adequate support

  19. Treatment strategies for mass burn casualties

    Institute of Scientific and Technical Information of China (English)

    CHAI Jia-ke; SHENG Zhi-yong; YANG Hong-ming; HAO Dai-feng; SHEN Chuan-an; JIA Xiao-ming; LI Feng; JING Sa; LI Li-gen; SONG Hui-feng; JIA Chi-yu; TUO Xiao-ye; SUN Tian-jun; HU Quan

    2009-01-01

    Background Mass burn casualties are always a great challenge to a medical team because a large number of seriously injured patients were sent in within a short time. Usually a high mortality is impending. Experiences gained from successful treatment of the victims may be useful in guiding the care of mass casualties in an armed conflict.Methods Thirty-five burn victims in a single batch, being transferred nonstop by air and highway from a distant province,were admitted 48 hours post-injury. All patients were male with a mean age of (22.4±8.7) years. The burn extent ranged from 4% to 75% ((13.6±12.9)%) total body surface area. Among them, thirty-two patients were complicated by moderate and severe inhalation injury, and tracheostomy had been performed in 15 patients. Decompression incisions of burn eschar on extremities were done in 17 cases before transportation. All the thirty-five patients arrived at the destination smoothly via 4-hour airlift and road transportation. Among them, twenty-five patients were in critical condition.Results These thirty-five patients were evacuated 6 hours from the scene of the injury, and they were transferred to a local hospital for primary emergency care. The patients were in very poor condition when admitted to our hospital because of the severe injury with delayed and inadequate treatment. Examination of these patients at admission showed that one patient was suffering from sepsis and multiple organ dysfunction syndrome. Dysfunction of the heart, lung, liver,kidney, and coagulation were all found in the patients. Forty-eight operations were performed in the 23 patients during one month together with comprehensive treatment, and the function of various organs was ameliorated after appropriate treatment. All the 35 patients survived.Conclusions A well-organized team consisting of several cooperative groups with specified duties is very important. As a whole, the treatment protocol should be individualized, basing on the extent of

  20. The effects of congestion charging on road traffic casualties: a causal analysis using difference-in-difference estimation.

    Science.gov (United States)

    Li, Haojie; Graham, Daniel J; Majumdar, Arnab

    2012-11-01

    This paper aims to identify the impacts of the London congestion charge on road casualties within the central London charging zone. It develops a full difference-in-difference (DID) model that is integrated with generalized linear models, such as Poisson and Negative Binomial regression models. Covariates are included in the model to adjust for factors that violate the parallel trend assumption, which is critical in the DID model. The lower Bayesian Information Criterion value suggests that the full difference-in-difference model performs well in evaluating the relationship between road accidents and the London congestion charge as well as other socio-economic factors. After adjusting for a time trend and regional effects, the results show that the introduction of the London congestion charge has a significant influence on the incidence of road casualties. The congestion charge reduces the total number of car accidents, but is associated with an increase in two wheeled vehicle accidents.

  1. Development of sulfanegen for mass cyanide casualties.

    Science.gov (United States)

    Patterson, Steven E; Moeller, Bryant; Nagasawa, Herbert T; Vince, Robert; Crankshaw, Daune L; Briggs, Jacquie; Stutelberg, Michael W; Vinnakota, Chakravarthy V; Logue, Brian A

    2016-06-01

    Cyanide is a metabolic poison that inhibits the utilization of oxygen to form ATP. The consequences of acute cyanide exposure are severe; exposure results in loss of consciousness, cardiac and respiratory failure, hypoxic brain injury, and dose-dependent death within minutes to hours. In a mass-casualty scenario, such as an industrial accident or terrorist attack, currently available cyanide antidotes would leave many victims untreated in the short time available for successful administration of a medical countermeasure. This restricted therapeutic window reflects the rate-limiting step of intravenous administration, which requires both time and trained medical personnel. Therefore, there is a need for rapidly acting antidotes that can be quickly administered to large numbers of people. To meet this need, our laboratory is developing sulfanegen, a potential antidote for cyanide poisoning with a novel mechanism based on 3-mercaptopyruvate sulfurtransferase (3-MST) for the detoxification of cyanide. Additionally, sulfanegen can be rapidly administered by intramuscular injection and has shown efficacy in many species of animal models. This article summarizes the journey from concept to clinical leads for this promising cyanide antidote.

  2. The Atomic Bomb Casualty Commission in retrospect

    Science.gov (United States)

    Putnam, Frank W.

    1998-01-01

    For 50 years, the Atomic Bomb Casualty Commission (ABCC) and its successor, the Radiation Effects Research Foundation (RERF), have conducted epidemiological and genetic studies of the survivors of the atomic bombs and of their children. This research program has provided the primary basis for radiation health standards. Both ABCC (1947–1975) and RERF (1975 to date) have been a joint enterprise of the United States (through the National Academy of Sciences) and of Japan. ABCC began in devastated, occupied Japan. Its mission had to be defined and refined. Early research revealed the urgent need for long term study. In 1946, a Directive of President Truman enjoined the National Research Council of the National Academy of Sciences to develop the program. By 1950, ABCC staff exceeded 1,000, and clinical and genetic studies were underway. Budgetary difficulties and other problems almost forced closure in 1953. In 1955, the Francis Report led to a unified epidemiological study. Much progress was made in the next decade, but changing times required founding of a binational nonprofit organization (RERF) with equal participation by Japan and the United States. New programs have been developed and existing ones have been extended in what is the longest continuing health survey ever undertaken. PMID:9576898

  3. Mass casualty modelling: a spatial tool to support triage decision making

    Directory of Open Access Journals (Sweden)

    Hameed Syed M

    2011-06-01

    Full Text Available Abstract Background During a mass casualty incident, evacuation of patients to the appropriate health care facility is critical to survival. Despite this, no existing system provides the evidence required to make informed evacuation decisions from the scene of the incident. To mitigate this absence and enable more informed decision making, a web based spatial decision support system (SDSS was developed. This system supports decision making by providing data regarding hospital proximity, capacity, and treatment specializations to decision makers at the scene of the incident. Methods This web-based SDSS utilizes pre-calculated driving times to estimate the actual driving time to each hospital within the inclusive trauma system of the large metropolitan region within which it is situated. In calculating and displaying its results, the model incorporates both road network and hospital data (e.g. capacity, treatment specialties, etc., and produces results in a matter of seconds, as is required in a MCI situation. In addition, its application interface allows the user to map the incident location and assists in the execution of triage decisions. Results Upon running the model, driving time from the MCI location to the surrounding hospitals is quickly displayed alongside information regarding hospital capacity and capability, thereby assisting the user in the decision-making process. Conclusions The use of SDSS in the prioritization of MCI evacuation decision making is potentially valuable in cases of mass casualty. The key to this model is the utilization of pre-calculated driving times from each hospital in the region to each point on the road network. The incorporation of real-time traffic and hospital capacity data would further improve this model.

  4. Modelling Mass Casualty Decontamination Systems Informed by Field Exercise Data

    Directory of Open Access Journals (Sweden)

    Richard Amlôt

    2012-10-01

    Full Text Available In the event of a large-scale chemical release in the UK decontamination of ambulant casualties would be undertaken by the Fire and Rescue Service (FRS. The aim of this study was to track the movement of volunteer casualties at two mass decontamination field exercises using passive Radio Frequency Identification tags and detection mats that were placed at pre-defined locations. The exercise data were then used to inform a computer model of the FRS component of the mass decontamination process. Having removed all clothing and having showered, the re-dressing (termed re-robing of casualties was found to be a bottleneck in the mass decontamination process during both exercises. Computer simulations showed that increasing the capacity of each lane of the re-robe section to accommodate 10 rather than five casualties would be optimal in general, but that a capacity of 15 might be required to accommodate vulnerable individuals. If the duration of the shower was decreased from three minutes to one minute then a per lane re-robe capacity of 20 might be necessary to maximise the throughput of casualties. In conclusion, one practical enhancement to the FRS response may be to provide at least one additional re-robe section per mass decontamination unit.

  5. The Application of Multi-objective Planning Theory in the Decision-making Management of Insurance Company --Taking the Line and Asset Structure Decision-making of Property and Casualty Insurance Company as an Example%多目标规划在保险公司决策管理中的应用研究——以产险公司业务和资产结构决策为例

    Institute of Scientific and Technical Information of China (English)

    李秀芳; 傅国耕

    2012-01-01

    本文在公司价值最大化的终极目标下,通过分析保险公司各个层级的发展目标,指出保险公司的决策管理具有多目标属性。在对多目标规划理论进行系统梳理的基础上,以产险公司的业务和资产结构决策为例,构建了以公司规模、利润和风险为目标的资本和监管约束下的多目标规划模型。分析发现,将多目标规划理论应用于保险公司管理中的确能够平衡不同目标的关系,有效提高公司经营的稳健性。%Under the premise of value maximization of insurance company, this paper analyzed the development objectives at different levels, and pointed out that the decision-making management of insurance company had a multi- ple objective property. Based on the systematic summary of the theory of multi-objective planning, the paper gave an example of the lines and assets structure of a property and casualty insurance company, and constructed a multi-ob- jective planning model covering the company's size, earnings and risks under the restraints of capital and regulation. It found out that, using the theory of multi-objective planning in the management of an insurance company could bal- ance the relationship of different goals, and improve operation robustness of the company.

  6. The role of cytogenetics in early triage of radiation casualties

    Energy Technology Data Exchange (ETDEWEB)

    Lloyd, D.C. E-mail: david.lloyd@nrpb.org.uk; Edwards, A.A.; Moquet, J.E.; Guerrero-Carbajal, Y.C

    2000-05-15

    Preliminary dose estimates by chromosomal analysis can be made rapidly in order to supplement early triage of radiation casualties based on clinical signs. An in vitro simulation of an accident with many casualties receiving whole or partial body exposure in the range 0-8 Gy is described. Faced with an urgent need for rapid results, confirmation of clinical triage can generally be obtained from scoring 20 metaphases per subject. Scoring should be increased to 50 cells where there is disagreement with the initial assessments or evidence of significantly inhomogeneous exposure.

  7. Health care worker protection in mass casualty respiratory failure: infection control, decontamination, and personal protective equipment.

    Science.gov (United States)

    Daugherty, Elizabeth L

    2008-02-01

    Maintenance of a safe and stable health care infrastructure is critical to an effective mass casualty disaster response. Both secondary contamination during chemical disasters and hospital-associated infections during epidemic illness can pose substantial threats to achieving this goal. Understanding basic principles of decontamination and infection control during responses to chemical and biologic disasters can help minimize the risks to patients and health care workers. Effective decontamination following toxic chemical exposure should include both removal of contaminated clothing and decontamination of the victim's skin. Wet decontamination is the most feasible strategy in a mass casualty situation and should be performed promptly by trained personnel. In the event of an epidemic, infection prevention and control measures are based on essential principles of hand hygiene and standard precautions. Expanded precautions should be instituted as needed to target contact, droplet, and airborne routes of infectious disease transmission. Specific equipment and measures for critical care delivery may serve to decrease risk to health care workers in the event of an epidemic. Their use should be considered in developing comprehensive disaster response plans.

  8. 26 CFR 1.165-7 - Casualty losses.

    Science.gov (United States)

    2010-04-01

    ... planted trees and ornamental shrubs on the grounds surrounding the building. In 1961 the land, building, trees, and shrubs are damaged by hurricane. At the time of the casualty the adjusted basis of the land is $18,000 and the adjusted basis of the building is $66,000. At that time the trees and shrubs...

  9. 46 CFR 169.807 - Notice of casualty.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Notice of casualty. 169.807 Section 169.807 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS..., navigation charts, navigation work books, compass deviation cards, gyrocompass records, record of draft,...

  10. Primate bites in Gibraltar--minor casualty quirk?

    Science.gov (United States)

    Campbell, A C

    1989-10-01

    In one year 55 patients presented to the casualty department of St Bernard's Hospital, Gibraltar, with a primate bite. The implications of such wounds on the health of these patients is contrasted with the morbidity and mortality associated with primate bites in the African subcontinent.

  11. "Bomb explosion on the Nis express" - lessons from a major incident, Kosovo 16 Feb 2001.

    Science.gov (United States)

    Vassallo, D J; Graham, P J K; Gupta, G; Alempijevic, Dj

    2005-03-01

    On Friday 16 February 2001, terrorists detonated a bomb under a civilian coach travelling from Nis in Serbia to Gracanica in Kosovo. 10 people were killed at the scene. 13 casualties were treated in the British KFOR hospital (Reynolds Hospital) in Pristina. Another 8 casualties were evacuated to the American KFOR hospital at Camp Bondsteel. The incident provided a unique opportunity for co-operation between British, American, Russian, German and French KFOR hospitals, as well as with Serbian clinicians and forensic pathologists. This article analyses the medical management of this major incident, identifies the lessons to be learned from it, and also provides enough detail for teaching scenarios.

  12. War casualties on the home front

    Energy Technology Data Exchange (ETDEWEB)

    Brenda J. Flinn

    2005-11-01

    On May 12, 1942, at Christopher coal mine No. 3 in Osage, West Virginia, a continent away from the frontlines of World War II, Superintendent Ed O'Neil saw the mine ventilation fan suddenly run backwards, propelled by a strong gust of air that tore the belt off the huge blower. The second shift mantrip of 115 coal miners, traversing the drift mouth for the 3:00 p.m. shift, ground to an uneasy halt. The article recounts the tragic consequences of this incident. It also tells of other events affecting coal miners during World War I and World War II.

  13. CBRNE TC3: A Hybrid Approach to Casualty Care in the CBRNE Environment.

    Science.gov (United States)

    Strain, John W

    2013-01-01

    The implementation of Tactical Combat Casualty Care (TCCC) guidelines for the Operation Enduring Freedom and Operation Iraqi Freedom contingency operations has dramatically reduced preventable combat deaths. A study of these principles and their application to medical treatment in the chemical, biological, radiological, nuclear, and high-yield explosives (CBRNE), weapons of mass destruction (WMD) environment is presented as a potential readiness and force multiplier for units engaged in this area of operations. Preparing medical operators for support of WMD sampling and mitigation missions requires extensive preventive medicine and post-exposure and downrange trauma threat preparedness. Training and equipping CBRN operators with treatment skills and appropriate interventional material requires pre-implementation planning specific to WMD threats (e.g., anthrax, radiation, organophosphates, and contaminated trauma). A scenario-based study reveals the tactics, techniques, and procedures for training, resourcing, and fielding the CBRN operator of the future.

  14. Preliminary quantitative assessment of earthquake casualties and damages

    DEFF Research Database (Denmark)

    Badal, J.; Vázquez-Prada, M.; González, Á.;

    2005-01-01

    Prognostic estimations of the expected number of killed or injured people and about the approximate cost associated with the damages caused by earthquakes are made following a suitable methodology of wide-ranging application. For the preliminary assessment of human life losses due to the occurrence...... of a relatively strong earthquake we use a quantitative model consisting of a correlation between the number of casualties and the earthquake magnitude as a function of population density. The macroseismic intensity field is determined in accordance with an updated anelastic attenuation law, and the number...... the local social wealth as a function of the gross domestic product of the country. This last step is performed on the basis of the relationship of the macroseismic intensity to the earthquake economic loss in percentage of the wealth. Such an approach to the human casualty and damage levels is carried out...

  15. Innovations in the En Route Care of Combat Casualties

    Science.gov (United States)

    2014-01-01

    capability of CCATT, some patients exceed that level of care in the ERC setting, particularly because of lung injuries and inadequate ventilation . To meet...remained in place for 16 days with no complications (Buckenmaier & Bleckner, 2008). One of the primary advantages of preoperative regional anesthesia ...constant innovation to ensure appropriate nursing care for combat casualties. Building on experiences in Iraq and Afghanistan, there have been tremendous

  16. A Predictive Model for Massive Transfusion in Combat Casualty Patients

    Science.gov (United States)

    2008-02-01

    A Predictive Model for Massive Transfusion in Combat Casualty Patients Daniel F . McLaughlin, MD, Sarah E. Niles, MD, MPH, Jose Salinas, PhD, Jeremy G...Silver Springs, Maryland. Address for reprints: Daniel F . McLaughlin, MD, United States Insti- tute of Surgical Research, 3400 Rawley E. Chambers...see that here? Thank you again for an excellent study, which I believe should alter practice for many of us. Dr. Daniel F . McLaughlin (US Army

  17. Strategies for casualty mitigation programs by using advanced tsunami computation

    Science.gov (United States)

    IMAI, K.; Imamura, F.

    2012-12-01

    1. Purpose of the study In this study, based on the scenario of great earthquakes along the Nankai trough, we aim on the estimation of the run up and high accuracy inundation process of tsunami in coastal areas including rivers. Here, using a practical method of tsunami analytical model, and taking into account characteristics of detail topography, land use and climate change in a realistic present and expected future environment, we examined the run up and tsunami inundation process. Using these results we estimated the damage due to tsunami and obtained information for the mitigation of human casualties. Considering the time series from the occurrence of the earthquake and the risk of tsunami damage, in order to mitigate casualties we provide contents of disaster risk information displayed in a tsunami hazard and risk map. 2. Creating a tsunami hazard and risk map From the analytical and practical tsunami model (a long wave approximated model) and the high resolution topography (5 m) including detailed data of shoreline, rivers, building and houses, we present a advanced analysis of tsunami inundation considering the land use. Based on the results of tsunami inundation and its analysis; it is possible to draw a tsunami hazard and risk map with information of human casualty, building damage estimation, drift of vehicles, etc. 3. Contents of disaster prevention information To improve the hazard, risk and evacuation information distribution, it is necessary to follow three steps. (1) Provide basic information such as tsunami attack info, areas and routes for evacuation and location of tsunami evacuation facilities. (2) Provide as additional information the time when inundation starts, the actual results of inundation, location of facilities with hazard materials, presence or absence of public facilities and areas underground that required evacuation. (3) Provide information to support disaster response such as infrastructure and traffic network damage prediction

  18. Wireless Vital Sign Sensor Network Simulations for Mass Casualty Response

    Science.gov (United States)

    2013-11-27

    Casualty, Network Simulation 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT: Unclassified 18. NUMBER OF PAGES 19 19a. NAME OF... security takes priority over medical treatment of the wounded, so it assumed that only two responders are available to provide medical care during...in ZigBee products. Since ZigBee software stacks are widely available and since a standard exists for ZigBee use in healthcare, it is a very

  19. Mass casualty events: blood transfusion emergency preparedness across the continuum of care.

    Science.gov (United States)

    Doughty, Heidi; Glasgow, Simon; Kristoffersen, Einar

    2016-04-01

    Transfusion support is a key enabler to the response to mass casualty events (MCEs). Transfusion demand and capability planning should be an integrated part of the medical planning process for emergency system preparedness. Historical reviews have recently supported demand planning for MCEs and mass gatherings; however, computer modeling offers greater insights for resource management. The challenge remains balancing demand and supply especially the demand for universal components such as group O red blood cells. The current prehospital and hospital capability has benefited from investment in the management of massive hemorrhage. The management of massive hemorrhage should address both hemorrhage control and hemostatic support. Labile blood components cannot be stockpiled and a large surge in demand is a challenge for transfusion providers. The use of blood components may need to be triaged and demand managed. Two contrasting models of transfusion planning for MCEs are described. Both illustrate an integrated approach to preparedness where blood transfusion services work closely with health care providers and the donor community. Preparedness includes appropriate stock management and resupply from other centers. However, the introduction of alternative transfusion products, transfusion triage, and the greater use of an emergency donor panel to provide whole blood may permit greater resilience.

  20. Characteristics of road traffic accident casualties admitted to a tertiary care hospital in Sri Lanka.

    Science.gov (United States)

    Fernando, Dinesh M; Tennakoon, Sampath U; Samaranayake, Achini N; Wickramasinghe, Medhani

    2017-03-01

    The mortality and morbidity of road traffic accidents (RTA) is increasing in the South Asian region, including Sri Lanka. Therefore, the demographic factors, types of vehicles involved, and the severity of injuries sustained in RTA was studied. Age, gender, and details of the incident of all patients admitted to hospital following a RTA, between January 2007 and August 2012, were obtained by interview. Following a medico-legal examination, the type and severity of injuries was categorized as, non-grievous, grievous, endangering life or fatal in the ordinary course of nature. Of the 579 RTA casualties examined, 72% were males, 28% females, and 26% were in the 20-29 year age group. There were 44% passengers, 32% drivers, and 20% pedestrians. Of the 440 vehicle occupants, 37% were on motor cycles, 28% in three wheelers, 13% in dual purpose vehicles and 11% in buses. Of the 114 pedestrians, 33% had been struck by motor cycles, 19% by three-wheelers and 17% by dual purpose vehicles. There was at least one soft tissue injury in 84%, whilst 45% had one or more fractures. In 85% of bicycle riders, the injuries were grievous, endangering life or fatal in the ordinary course of nature. A high proportion of young adults sustained grievous injuries due to RTA. Almost two thirds of the casualties resulted from motorcycle or three wheeler accidents. Laws limiting the number of passengers carried, installation of side doors, mandatory use of seat belts in three wheelers, and protective garments for motorcyclists are recommended.

  1. Benchmark analysis for quantifying urban vulnerability to terrorist incidents.

    Science.gov (United States)

    Piegorsch, Walter W; Cutter, Susan L; Hardisty, Frank

    2007-12-01

    We describe a quantitative methodology to characterize the vulnerability of U.S. urban centers to terrorist attack, using a place-based vulnerability index and a database of terrorist incidents and related human casualties. Via generalized linear statistical models, we study the relationships between vulnerability and terrorist events, and find that our place-based vulnerability metric significantly describes both terrorist incidence and occurrence of human casualties from terrorist events in these urban centers. We also introduce benchmark analytic technologies from applications in toxicological risk assessment to this social risk/vulnerability paradigm, and use these to distinguish levels of high and low urban vulnerability to terrorism. It is seen that the benchmark approach translates quite flexibly from its biological roots to this social scientific archetype.

  2. CORTIM Project: Medical Regulation Concept Designed for Forward Field Casualty Management Based on an Information System

    Science.gov (United States)

    2010-04-01

    CORTIM, and the quality of casualty handling by the SAMU (the French Mobile Emergency Medical Service) for the RMT concept. We consider that...of crisis situations in the case of CORTIM, and the quality of casualty handling by the SAMU (the French Mobile Emergency Medical Service) for the... SAMU for the RMT concept. We consider that operational casualty management can be enhanced in at least three areas. The first concerns improvements in

  3. 77 FR 52746 - Medical Countermeasures for a Burn Mass Casualty Incident

    Science.gov (United States)

    2012-08-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... adverse health consequences arising from public health emergencies, specifically those involving... register online by 5 p.m. on September 21, 2012. Early registration is recommended because facilities...

  4. Rotorcraft Use in Disaster Relief and Mass Casualty Incidents - Case Studies

    Science.gov (United States)

    1990-06-01

    ground-fault within a combustible concealed space in a waitresses serving station of The Deli. Following full involvement of The Deli, a flame front...entirely limited to the Casino level and second floor office area. There was minor flame damage on one or two guest rooms on the fifth floor and heat and...smoke damage on upper floors , but the major damage by fire was in the Main Casino, the lobby areas at the main and Flamingo Road entrances, the hotel

  5. Incidence of Pulmonary Embolus in Combat Casualties With Extremity Amputations and Fractures

    Science.gov (United States)

    2011-09-01

    Bethesda, Maryland; and Integrated Depart- ment of Orthopedics and Rehabilitation (K.N.E., J.A.F.), Walter Reed Na- tional Military Medical Center...6.5%) Other 8 (3.0%) Hospital course Days from injury to arrival at· NNMC 6.47 :!: 7.8 LOS 27.17 20.5 Ventilator days 2.18 ::t 5.8 ICU days...provide the greatest rehabilitation ability. It is well documented that surgery alone is a risk factor for development of a VTE.D This was seen in our

  6. The incidence of heat casualties in sprint triathlon: the tale of two Melbourne race events.

    Science.gov (United States)

    Gosling, Cameron McR; Gabbe, Belinda J; McGivern, Jeanne; Forbes, Andrew B

    2008-01-01

    Triathlon is a popular participation sport combining swimming, cycling and running into a single event. The Triathlon Australia medical policy advocates the use of wet bulb globe temperature as the criterion for altering race distance and an ambient temperature of 35 degrees C as a criterion for consideration of cancellation of an event, but there is little empirical evidence detailing the effectiveness of this policy. Nor has the impact of environmental thermal stress on triathletes in shorter duration events been determined. During an injury surveillance investigation of a triathlon race series over the 2006/2007 seasons, two events with similar environmental conditions were completed. One thousand eight hundred and eighty-four participants competed in event 1 (December 2006) and 2000 competed in event 2 (February 2007). Maximum dry bulb (DBT), minimum vapour pressure (VP) and minimum relative humidity (RH) for event 1 were 37 degrees C DBT, 0.56 kPa VP and 9% RH measured by the Bureau of Meteorology. Fifty-three participants presented for medical aid, 15 due to heat-related collapse. The conditions measured for event 2 were 33 degrees C DBT, 1.16 kPa VP and 24% RH and there were no heat illness presentations despite 38 individuals presenting for medical aid. These observations suggest that the risk of heat-related collapse is greatest when high-environmental temperatures occur early in the competitive season when participants may be inadequately prepared and have not yet acquired natural acclimatisation to heat. Any Triathlon Australia policy revision could place stronger emphasis on the use of ambient temperature as a limiting criterion for race organisers.

  7. Drone Strikes in Pakistan: Reasons to Assess Civilian Casualties

    Science.gov (United States)

    2014-04-01

    photo: An MQ-9 Reaper, armed with GB U-12 Paveway II laser guided munitions and AGM-114 Hellfire missiles, piloted by Col. Lex Turner flies a combat...campaign. v \\Te observe that drone strikes in Pakistan were more likely to cause civilian casualties on av- erage than drone stiikes by military forces in...T11e Times (London) ,July 26, 2012. V \\!hilc not accomplished with a drone strike, that raid represents one end of a spectnnn with regard to trading

  8. 33 CFR 150.825 - Reporting a diving-related casualty.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Reporting a diving-related casualty. 150.825 Section 150.825 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Reporting a diving-related casualty. Deaths and injuries related to diving within the safety zone of...

  9. On the Temporal Distribution of Casualties and Determination of Medical Logistical Requirements

    CERN Document Server

    Lauren, Michael Kyle

    2012-01-01

    It is demonstrated that World War II casualty data display statistical structure that would be expected from multifractal data. Given that the data displayed these properties, it is shown how the existence of power-law tails in the exceedence probability distributions can be used to estimate the likelihood of various casualty levels. Estimates made using this method matched the historical data well.

  10. 77 FR 8956 - Surety Companies Acceptable on Federal Bonds: Grange Mutual Casualty Company

    Science.gov (United States)

    2012-02-15

    ... Supplement No. 7 to the Treasury Department Circular 570, 2011 Revision, published July 1, 2011, at 76 FR... Fiscal Service Surety Companies Acceptable on Federal Bonds: Grange Mutual Casualty Company AGENCY.... 9305 to the following company: Grange Mutual Casualty Company (NAIC 14060). Business Address: 671...

  11. Comparative analysis of showering protocols for mass-casualty decontamination.

    Science.gov (United States)

    Amlot, Richard; Larner, Joanne; Matar, Hazem; Jones, David R; Carter, Holly; Turner, Elizabeth A; Price, Shirley C; Chilcott, Robert P

    2010-01-01

    A well-established provision for mass-casualty decontamination that incorporates the use of mobile showering units has been developed in the UK. The effectiveness of such decontamination procedures will be critical in minimizing or preventing the contamination of emergency responders and hospital infrastructure. The purpose of this study was to evaluate three empirical strategies designed to optimize existing decontamination procedures: (1) instructions in the form of a pictorial aid prior to decontamination; (2) provision of a washcloth within the showering facility; and (3) an extended showering period. The study was a three-factor, between-participants (or "independent") design with 90 volunteers. The three factors each had two levels: use of washcloths (washcloth/no washcloth), washing instructions (instructions/no instructions), and shower cycle duration (three minutes/six minutes). The effectiveness of these strategies was quantified by whole-body fluorescence imaging following application of a red fluorophore to multiple, discrete areas of the skin. All five showering procedures were relatively effective in removing the fluorophore "contaminant", but the use of a cloth (in the absence of instructions) led to a significant ( appox. 20%) improvement in the effectiveness of decontamination over the standard protocol (p mass-casualty decontamination effectiveness, especially in children, can be optimized by the provision of a washcloth. This simple but effective approach indicates the value of performing controlled volunteer trials for optimizing existing decontamination procedures.

  12. Managing bioterrorism mass casualties in an emergency department: lessons learned from a rural community hospital disaster drill.

    Science.gov (United States)

    Vinson, Eric

    2007-01-01

    Bioterrorism represents a threat for which most emergency departments (EDs) are ill prepared. In order to develop an evidence-based plan for ED and hospital management of contaminated patients, a review was conducted of the most effective strategies developed during the severe acute respiratory syndrome (SARS) epidemic, as well as Centers for Disease Control and Prevention and military guidelines on biowarfare. Six basic steps were identified: 1) lock down the hospital and control access to the ED; 2) protect emergency care personnel with appropriate personal protective equipment; 3) decontaminate and triage patients; 4) isolate patients; 5) treat patients with appropriate medications or measures, including decontamination of wounds; and 6) use restrictive admission and transfer guidelines. By emphasizing these six basic concepts, a rural ED passed an annual state-run bioterrorism mass-casualty drill. The drill provided health care personnel with the knowledge and skills necessary to prepare for future bioterrorism casualties. These same concepts could also be used to manage highly virulent viral or bacterial outbreaks.

  13. State propaganda and mental disorders: the issue of psychiatric casualties among Japanese soldiers during the Asia-Pacific War.

    Science.gov (United States)

    Matsumura, Janice

    2004-01-01

    This article explores the politics of Japanese wartime medical policy, demonstrating how state propaganda about the people and their armed forces influenced authoritative views on health and what might endanger it. By focusing on the obstacles faced by psychiatrists trying to promote more official concern for mental health issues, it challenges the validity of figures indicating a low incidence of psychological trauma among the country's soldiers. Civilian psychiatrists had to contend with the threat of censorship and arrest for even discussing war-induced mental disorders; at the same time, army psychiatrists as military insiders were pressured to convince their patients that their conditions were not serious and did not merit compensation. While discussing the neglected topic of Japanese psychiatric casualties, an attempt is made to provide a comparative approach by referring to the state of military psychiatry in other national settings.

  14. State Methods for a Cyber Incident

    Science.gov (United States)

    2012-03-01

    Statewide Emergency Response and Response Plan SIPC State Infrastructure Protection Center SIRT Security Incident Response Team SIRT State Incident...by statute and policy to report agency information security incidents to the state Security Incident Response Team ( SIRT ). Those reports are made...through recent state statutes. P-16 Yes, agencies are required by statute and policy to report information security incidents to the SIRT . Q-17

  15. Rural casualty crashes on the Kings Highway: A new approach for road safety studies.

    Science.gov (United States)

    Alian, Sahar; Baker, R G V; Wood, Stephen

    2016-10-01

    This paper will consider the contribution that changes in road geometry and driver visual information make to the incidence and distribution of road casualties in different driving environments. This relationship will be explored specifically for the Kings Highway, a major arterial road connecting Queanbeyan with coastal southern New South Wales, Australia. It introduces and suggests a new empirical approach of plotting crashes with road segmentation, calculating sinuosity indices and grades as key features of road geometry, and critical visual points as a behavioural component of road curvature, within a GIS context. It is an approach that might be used when detailed road geometry data is not available. The visualisation and segmentation approach in this research might be used for summarising crash rates and road geometry factors, and for comparing day/night and eastbound/westbound driving conditions. The results suggest some early interpretations for detailed road safety studies that might be considered at local or national levels. The rate of crashes increases according to changes in road geometry factors during the day and for eastbound travel. This is not the case for night driving where the incidence of crashes is similar on both straight and curved roads segments due to the headlight effect and limited background visual field. Crash clusters at day-time may be due to the stronger effect of road geometry (e.g. combination of curvature and vertical grade) on driver behaviour travelling eastbound. The outcomes suggest that it might be essential to consider the effect of environmental factors in any road safety and crash analysis studies.

  16. A Casualty in the Class War: Canada's Medicare.

    Science.gov (United States)

    Evans, Robert G

    2012-02-01

    "There's class warfare, all right, but it's my class, the rich class, that's making war, and we're winning." (Warren Buffett, five years ago.) Last year's Occupy Wall Street movement suggested that people are finally catching on. Note, making war: Buffett meant that there was deliberate intent and agency behind the huge transfer of wealth, since 1980, from the 99% to the 1%. Nor is the war metaphorical. There are real casualties, even if no body bags. Sadly, much Canadian commentary on inequality is pitiably naïve or deliberately obfuscatory. The 1% have captured national governments. The astronomical cost of American elections excludes the 99%. In Canada, parliamentary government permits one man to rule as a de facto dictator. The 1% don't like medicare.

  17. Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions.

    Science.gov (United States)

    Burkle, Frederick M

    2002-05-01

    The threat of a BT event has catalyzed serious reflection on the troublesome issues that come with event management and triage. Such reflection has had the effect of multiplying the efforts to find solutions to what could become a catastrophic public health disaster. Management options are becoming more robust, as are reliable detection devices and rapid access to stockpiled antibiotics and vaccines. There is much to be done, however, especially in the organizing, warehousing, and granting/exercising authority for resource allocations. The introduction of these new options should encourage one to believe that, in time, evolving standards of care will make it possible to rethink the currently unthinkable consequences. Unfortunately the cost of such preparedness is high and out of reach of most governments. Most of the developing world has neither the will nor the means to plan for BT events and remains overwhelmed with basic public health concerns (i.e., water, food, sanitation, shelter) that must take priority. Therefore, developed countries will be expected to respond using international exogenous resources to mitigate the effects of such a disaster. As a result, the state capacity of the effected government will be severely compromised. If triage and management of casualties is further compromised, terrorists will have met their goals. One could argue that health sciences will continue for decades to play catch up with the advanced technology driving potential bioagent weaponry. If one lesson was learned from the review of the former Soviet Union's biological weapons program, it is that the unthinkable remains an option to terrorists who have comparable expertise. It is crucial to develop realistic strategies for a BT event. Triage planning (the process of establishing criteria for health care prioritization) permits society to see cases in the context of diverse moral perspectives, limited resources, and compelling health care demands. This includes a competent

  18. [Critical incidents].

    Science.gov (United States)

    Scheidegger, D

    2005-03-01

    In medicine real severe mishaps are rare. On the other hand critical incidents are frequent. Anonymous critical incident reporting systems allow us to learn from these mishaps. This learning process will make our daily clinical work safer Unfortunately, before these systems can be used efficiently our professional culture has to be changed. Everyone in medicine has to admit that errors do occur to see the need for an open discussion. If we really want to learn from errors, we cannot punish the individual, who reported his or her mistake. The interest is primarily in what has happened and why it has happened and not who has committed this mistake. The cause for critical incidents in medicine is in over 80% the human factor Poor communication, work under enormous stress, conflicts and hierarchies are the main cause. This has been known for many years, therefore have already 15 years ago high-tech industries, like e.g. aviation, started to invest in special courses on team training. Medicine is a typical profession were until now only the individual performance decided about the professional career Communication, conflict management, stress management, decision making, risk management, team and team resource management were subjects that have never been taught during our preor postgraduate education. These points are the most important ones for an optimal teamwork. A multimodular course designed together with Swissair (Human Aspect Development medical, HADmedical) helps to cover, as in aviation, the soft factor and behavioural education in medicine and to prepare professionals in health care to work as a real team.

  19. Defense Health: Actions Needed to Help Ensure Combat Casualty Care Research Achieves Goals

    Science.gov (United States)

    2013-02-01

    Department of Health and Human Services JPC -6 Joint Program Committee for Combat Casualty Care MRMC Army Medical Research and...and development.) Note: The JPC -6 includes representatives from each military service (Army, Navy, Air Force, and Marine Corps) and is chartered...care, which is managed by the Joint Program Committee for Combat Casualty Care ( JPC -6). The JPC -6 includes representatives from the DOD biomedical

  20. Nuclear and radiological risk: contaminated mass casualties in the hospital; Risque nucleaire et radiologique: l'afflux massif de victimes contaminees a l'hopital

    Energy Technology Data Exchange (ETDEWEB)

    Telion, C.; Lejay, M.; Carli, P. [Hopital Necker Enfants Malades, SAMU de Paris et DAR, 75 - Paris (France)

    2006-08-15

    The basic scenario for the medical response organization is the explosion of the dirty bomb in public places spreading radioactive material and contaminating casualties. The French plan gives precise directions for the organization of the emergency room and the simple protective measures for medical staff and equipment to avoid dissemination and contamination into the hospital. Decontamination consists of the undressing of the victims followed by showering. The detection of the contamination can limit the time-consuming unnecessary decontamination procedure and the radioactive waste. Medical and paramedical staff is trained to wear protective disposal paper suits and to direct the procedure of decontamination. (author)

  1. A decision support system for managing forest fire casualties.

    Science.gov (United States)

    Bonazountas, Marc; Kallidromitou, Despina; Kassomenos, Pavlos; Passas, Nikos

    2007-09-01

    Southern Europe is exposed to anthropogenic and natural forest fires. These result in loss of lives, goods and infrastructure, but also deteriorate the natural environment and degrade ecosystems. The early detection and combating of such catastrophes requires the use of a decision support system (DSS) for emergency management. The current literature reports on a series of efforts aimed to deliver DSSs for the management of the forest fires by utilising technologies like remote sensing and geographical information systems (GIS), yet no integrated system exists. This manuscript presents the results of scientific research aiming to the development of a DSS for managing forest fires. The system provides a series of software tools for the assessment of the propagation and combating of forest fires based on Arc/Info, ArcView, Arc Spatial Analyst, Arc Avenue, and Visual C++ technologies. The system integrates GIS technologies under the same data environment and utilises a common user interface to produce an integrated computer system based on semi-automatic satellite image processing (fuel maps), socio-economic risk modelling and probabilistic models that would serve as a useful tool for forest fire prevention, planning and management. Its performance has been demonstrated via real time up-to-date accurate information on the position and evolution of the fire. The system can assist emergency assessment, management and combating of the incident. A site demonstration and validation has been accomplished for the island of Evoia, Greece, an area particularly vulnerable to forest fires due to its ecological characteristics and prevailing wind patterns.

  2. Rough terrain motion planning for actively reconfigurable mobile robots

    Energy Technology Data Exchange (ETDEWEB)

    Brunner, Michael

    2015-02-05

    In the aftermath of the Tohoku earthquake and the nuclear meltdown at the power plant of Fukushima Daiichi in 2011, reconfigurable robots like the iRobot Packbot were deployed. Instead of humans, the robots were used to investigate contaminated areas. Other incidents are the two major earthquakes in Northern Italy in May 2012. Besides many casualties, a large number of historical buildings was severely damaged. Due to the imminent danger of collapse, it was too dangerous for rescue personnel to enter many of the buildings. Therefore, the sites were inspected by reconfigurable robots, which are able to traverse the rubble and debris of the partially destroyed buildings. This thesis develops a navigation system enabling wheeled and tracked robots to safely traverse rough terrain and challenging structures. It consists of a planning mechanism and a controller. The focus of this thesis, however, is on the contribution to motion planning. The planning scheme employs a hierarchical approach to motion planning for actively reconfigurable robots in rough environments. Using a map of the environment the algorithm estimates the traversability under the consideration of uncertainties. Based on this analysis, an initial path search determines an approximate solution with respect to the robot's operating limits.Subsequently, a detailed planning step refines the initial path where it is required. The refinement step considers the robot's actuators and stability in addition to the quantities of the first search. Determining the robot-terrain interaction is very important in rough terrain. This thesis presents two path refinement approaches: a deterministic and a randomized approach. The experimental evaluation investigates the separate components of the planning scheme, the robot-terrain interaction for instance.In simulation as well as in real world experiments the evaluation demonstrates the necessity of such a planning algorithm in rough terrain and it provides

  3. Infrared imaging-based combat casualty care system

    Science.gov (United States)

    Davidson, James E., Sr.

    1997-08-01

    A Small Business Innovative Research (SBIR) contract was recently awarded to a start up company for the development of an infrared (IR) image based combat casualty care system. The company, Medical Thermal Diagnostics, or MTD, is developing a light weight, hands free, energy efficient uncooled IR imaging system based upon a Texas Instruments design which will allow emergency medical treatment of wounded soldiers in complete darkness without any type of light enhancement equipment. The principal investigator for this effort, Dr. Gene Luther, DVM, Ph.D., Professor Emeritus, LSU School of Veterinary Medicine, will conduct the development and testing of this system with support from Thermalscan, Inc., a nondestructive testing company experienced in IR thermography applications. Initial research has been done with surgery on a cat for feasibility of the concept as well as forensic research on pigs as a close representation of human physiology to determine time of death. Further such studies will be done later as well as trauma studies. IR images of trauma injuries will be acquired by imaging emergency room patients to create an archive of emergency medical situations seen with an infrared imaging camera. This archived data will then be used to develop training material for medical personnel using the system. This system has potential beyond military applications. Firefighters and emergency medical technicians could directly benefit from the capability to triage and administer medical care to trauma victims in low or no light conditions.

  4. Prairie North: a joint civilian/military mass casualty exercise highlights the role of the National Guard in community disaster response.

    Science.gov (United States)

    Vukotich, George; Bayram, Jamil D; Miller, Miriam I

    2012-01-01

    In a joint military/civilian exercise conducted in June 2010, military National Guard medical and decontamination response efforts proved to be paramount in supporting hospital resources to sustain an adequate response during a simulated terrorist event. Traditionally, hospitals include local responders in their disaster preparedness but overlook other available state and federal resources such as the National Guard. Lessons learned from the exercise included the value of regular joint disaster planning and training between the military and civilian medical sectors. Additionally, military communication and medical equipment compatibility with the civilian infrastructure was identified as one of the top areas for the improvement of this joint exercise. Involving the National Guard in community disaster planning provides a valuable medical support asset that can be critical in responding to multiple casualty events. National Guard response is inherently faster than its federal counterpart. Based on the findings from our joint exercise, states are encouraged to incorporate their corresponding National Guard in civilian critical medical infrastructure disaster preparedness activities, as the National Guard can be an integral part of the disaster response efforts in real multiple casualty events.

  5. Planning for the next influenza pandemic: using the science and art of logistics.

    Science.gov (United States)

    Cupp, O Shawn; Predmore, Brad G

    2011-01-01

    The complexities and challenges for healthcare providers and their efforts to provide fundamental basic items to meet the logistical demands of an influenza pandemic are discussed in this article. The supply chain, planning, and alternatives for inevitable shortages are some of the considerations associated with this emergency mass critical care situation. The planning process and support for such events are discussed in detail with several recommendations obtained from the literature and the experience from recent mass casualty incidents (MCIs). The first step in this planning process is the development of specific triage requirements during an influenza pandemic. The second step is identification of logistical resources required during such a pandemic, which are then analyzed within the proposed logistics science and art model for planning purposes. Resources highlighted within the model include allocation and use of work force, bed space, intensive care unit assets, ventilators, personal protective equipment, and oxygen. The third step is using the model to discuss in detail possible workarounds, suitable substitutes, and resource allocation. An examination is also made of the ethics surrounding palliative care within the construction of an MCI and the factors that will inevitably determine rationing and prioritizing of these critical assets to palliative care patients.

  6. Principles of disaster planning for the pediatric population.

    Science.gov (United States)

    Allen, Gwenn M; Parrillo, Steven J; Will, Jean; Mohr, Johnathon A

    2007-01-01

    Unique physiological, developmental, and psychological attributes of children make them one of the more vulnerable populations during mass-casualty incidents. Because of their distinctive vulnerabilities, it is crucial that pediatric needs are incorporated into every stage of disaster planning. Individuals, families, and communities can help mitigate the effects of disasters on pediatric populations through ongoing awareness and preventive practices. Mitigation efforts also can be achieved through education and training of the healthcare workforce. Preparedness activities include gaining Emergency Medical Services for Children Pediatric Facility Recognition, conducting pediatric disaster drills, improving pediatric surge capacity, and ensuring that the needs of children are incorporated into all levels of disaster plans. Pediatric response can be improved in a number of ways, including: (1) enhanced pediatric disaster expertise; (2) altered decontamination protocols that reflect pediatric needs; and (3) minimized parent-child separation. Recovery efforts at the pediatric level include promoting specific mental health therapies for children and incorporating children into disaster relief and recovery efforts. Improving pediatric emergency care needs should be at the forefront of every disaster planner's agenda.

  7. Use of Clinical Decision Guidance as a New Public Health Tool for the Medical Management of Internal Contamination in Radiological Mass Casualty Scenarios.

    Science.gov (United States)

    Wiley, Albert L

    2016-09-01

    This review is a discussion of special issues associated with the medical and public health management of persons at risk of internal contamination from radionuclides, following various radiological mass-casualty scenarios, as well as definition, discussion and use of the Clinical Decision Guidance (CDG) in such scenarios. Specific medical countermeasures are available for reducing the internal radiation dose and the subsequent stochastic and deterministic risks to persons internally contaminated with radionuclides from nuclear power plant, fuel processing and nuclear weapon accidents/incidents. There is a public health need for rapidly identifying and quantifying the 'source term' of such radiation exposures and assessment of the associated committed doses, so that appropriate medical countermeasure(s) can be given as soon as possible. The CDG, which was initially defined in NCRP-161, was specifically developed to be a new public health tool for facilitating the integration of local community healthcare professionals into the general medical, mass casualty, triage and treatment response of internally contaminated populations.

  8. Benefits of multidisciplinary collaboration for earthquake casualty estimation models: recent case studies

    Science.gov (United States)

    So, E.

    2010-12-01

    Earthquake casualty loss estimation, which depends primarily on building-specific casualty rates, has long suffered from a lack of cross-disciplinary collaboration in post-earthquake data gathering. An increase in our understanding of what contributes to casualties in earthquakes involve coordinated data-gathering efforts amongst disciplines; these are essential for improved global casualty estimation models. It is evident from examining past casualty loss models and reviewing field data collected from recent events, that generalized casualty rates cannot be applied globally for different building types, even within individual countries. For a particular structure type, regional and topographic building design effects, combined with variable material and workmanship quality all contribute to this multi-variant outcome. In addition, social factors affect building-specific casualty rates, including social status and education levels, and human behaviors in general, in that they modify egress and survivability rates. Without considering complex physical pathways, loss models purely based on historic casualty data, or even worse, rates derived from other countries, will be of very limited value. What’s more, as the world’s population, housing stock, and living and cultural environments change, methods of loss modeling must accommodate these variables, especially when considering casualties. To truly take advantage of observed earthquake losses, not only do damage surveys need better coordination of international and national reconnaissance teams, but these teams must integrate difference areas of expertise including engineering, public health and medicine. Research is needed to find methods to achieve consistent and practical ways of collecting and modeling casualties in earthquakes. International collaboration will also be necessary to transfer such expertise and resources to the communities in the cities which most need it. Coupling the theories and findings from

  9. The effect of an out-of-hours reform on attendance at casualty wards. The Danish example

    DEFF Research Database (Denmark)

    Vedsted, Peter; Christensen, Morten Bondo

    2001-01-01

    in the attendance rate with casualty wards after the reform was statistically insignificant. CONCLUSIONS: The decrease in the total number of contacts with the out-of-hours primary health care after the reform was not met by a corresponding increase in casualty ward contacts. A clear-cut significant increase...

  10. Timing and Location of Blood Product Transfusion and Outcomes in Massively Transfused Combat Casualties

    Science.gov (United States)

    2012-01-01

    blood components in a 1:1:1 ratio of platelets:fresh frozen plasma:red blood cells (RBCs) is based on analyses of massive transfusion (MT, Q10 RBC units in 24 hours). These 24-hour analyses are weakened by survival bias and do not describe the timing and location of transfusions. Mortality outcomes associated with early (first 6 hours) resuscitation incorporating platelets, for combat casualties requiring MT, have not been reported. METHODS: We analyzed records for 8,618 casualties treated at the United States military hospital in Baghdad, Iraq, between January 2004 and

  11. Development of a national burn network: providing a co-ordinated response to a burn mass casualty disaster within the Australian health system

    Directory of Open Access Journals (Sweden)

    AG Robertson

    2008-01-01

    Full Text Available With the threat of terrorist activity ever present since the incidents in Bali and Jakarta, the Australian health system must be prepared to manage another mass burn casualty disaster. The Australian and New Zealand Burns Association (ANZBA highlighted the lack of a national burn disaster response before the 2000 Olympics. With the limited number of burn beds available and the protracted length of stay after such injuries, any state or territory could be overwhelmed with relatively few patient admissions. In 2002, the Australian Health Minister's Conference called for a solution. The objective of this paper is to provide an overview of the process and development of the Australian National Burn Network, which underpins the National Burn Disaster Response (AUSBURNPLAN.

  12. Biological dosimetry by the triage dicentric chromosome assay: potential implications for treatment of acute radiation syndrome in radiological mass casualties.

    Science.gov (United States)

    Romm, Horst; Wilkins, Ruth C; Coleman, C Norman; Lillis-Hearne, Patricia K; Pellmar, Terry C; Livingston, Gordon K; Awa, Akio A; Jenkins, Mark S; Yoshida, Mitsuaki A; Oestreicher, Ursula; Prasanna, Pataje G S

    2011-03-01

    Biological dosimetry is an essential tool for estimating radiation dose. The dicentric chromosome assay (DCA) is currently the tool of choice. Because the assay is labor-intensive and time-consuming, strategies are needed to increase throughput for use in radiation mass casualty incidents. One such strategy is to truncate metaphase spread analysis for triage dose estimates by scoring 50 or fewer metaphases, compared to a routine analysis of 500 to 1000 metaphases, and to increase throughput using a large group of scorers in a biodosimetry network. Previously, the National Institutes for Allergies and Infectious Diseases (NIAID) and the Armed Forces Radiobiology Research Institute (AFRRI) sponsored a double-blinded interlaboratory comparison among five established international cytogenetic biodosimetry laboratories to determine the variability in calibration curves and in dose measurements in unknown, irradiated samples. In the present study, we further analyzed the published data from this previous study to investigate how the number of metaphase spreads influences dose prediction accuracy and how this information could be of value in the triage and management of people at risk for the acute radiation syndrome (ARS). Although, as expected, accuracy decreased with lower numbers of metaphase spreads analyzed, predicted doses by the laboratories were in good agreement and were judged to be adequate to guide diagnosis and treatment of ARS. These results demonstrate that for rapid triage, a network of cytogenetic biodosimetry laboratories can accurately assess doses even with a lower number of scored metaphases.

  13. Design and characterisation of a novel in vitro skin diffusion cell system for assessing mass casualty decontamination systems.

    Science.gov (United States)

    Matar, H; Larner, J; Kansagra, S; Atkinson, K L; Skamarauskas, J T; Amlot, R; Chilcott, R P

    2014-06-01

    The efficient removal of contaminants from the outer surfaces of the body can provide an effective means of reducing adverse health effects associated with incidents involving the accidental or deliberate release of hazardous materials. Showering with water is frequently used by first responders as a rapid method of mass casualty decontamination (MCD). However, there is a paucity of data on the generic effectiveness and safety of aqueous decontamination systems. To address these issues, we have developed a new in vitro skin diffusion cell system to model the conditions of a common MCD procedure ("ladder pipe system"). The new diffusion cell design incorporates a showering nozzle, an air sampling port for measurement of vapour loss and/aerosolisation, adjustable (horizontal to vertical) skin orientation and a circulating manifold system (to maintain a specified flow rate, temperature and pressure of shower water). The dermal absorption characteristics of several simulants (Invisible Red S, curcumin and methyl salicylate) measured with the new in vitro model were in good agreement with previous in vitro and in vivo studies. Moreover, these initial studies have indicated that whilst flow rate and water temperature are important factors for MCD, the presence of clothing during showering may (under certain circumstances) cause transfer and spreading of contaminants to the skin surface.

  14. Derivation of Candidates for the Combat Casualty Critical Care (C4) Database

    Science.gov (United States)

    2014-04-01

    MILITARY MEDICINE, 179, 4:370, 2014 Derivation of Candidates for the Combat Casualty Critical Care (C4) Database Maj Ian J. Stewart, USAF MC*; Col...Trauma Nurs 2008; 15: 181–4. 13. Hunt JP, Cherr GS, Hunter C, et al: Accuracy of administrative data in trauma: splenic injuries as an example. J

  15. 27 CFR 25.282 - Beer lost by fire, theft, casualty, or act of God.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Beer lost by fire, theft... TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Refund or Adjustment of Tax or Relief From Liability § 25.282 Beer lost by fire, theft, casualty, or act of God. (a) General. The tax paid...

  16. Combat Casualties Undergoing Lifesaving Interventions Have Decreased Heart Rate Complexity at Multiple Time Scales

    Science.gov (United States)

    2013-01-01

    and cardioversion. 2.2. Data acquisition and analysis Upon admission to the ED, casualties were placed on a PIC 50 vital signs monitor (Welch...patient data Variable Age (y) Sex (male) Blunt or explosive mechanism HR (beats/ min) SAP (mm Hg) GCSIOtal GCSmo10r LSI (n = 12) 23 ± 15

  17. 77 FR 75263 - Surety Companies Acceptable on Federal Bonds: Termination; ULLICO Casualty Company

    Science.gov (United States)

    2012-12-19

    ... Supplement No. 3 to the Treasury Department Circular 570; 2012 Revision, published July 2, 2012, at 77 FR... Fiscal Service Surety Companies Acceptable on Federal Bonds: Termination; ULLICO Casualty Company AGENCY... Company (NAIC 37893) under 31 U.S.C. 9305 to qualify as an acceptable surety on Federal bonds...

  18. Medical Management of Radiological Casualties Handbook. First Edition

    Science.gov (United States)

    1999-12-01

    carcinogenesis. Irradiation in the fetal pe- riod leads to the most pronounced permanent growth retardation. The peak incidence of teratogenesis , or...abnormal genetic burden of future cellular generations. This has not been documented in humans. Fetal Exposure The four main effects of ionizing radiation...on the fetus are growth retardation; severe congenital malformations (including errors of metabolism); embryonic, fetal , or neo- 38 natal death; and

  19. ARDS: Risk Factors, Prognostic Factors, Management and Outcomes. Incidence and Mortality of ARDS in Combat Casualty Care

    Science.gov (United States)

    2009-07-01

    important to both maintain readiness and force protection, as well as in the continued provision of clinical care during transport and in the provision...one level of care (10 subjects had multiple CPT codes). Number Code N 31.1 TEMPORARY TRACHEOSTOMY 18 33.21 BRONCHOSCOPY THRU STOMA 4 33.22 FIBER...support hospitals, is particularly important to both maintain readiness and force protection, as well as in the continued provision of clinical care

  20. EMS Response to Mass Casualty Incidents: The Critical Importance of Automatic Statewide Mutual Aid and MCI Training

    Science.gov (United States)

    2008-09-01

    tasks with associated challenges or barriers that had to be overcome in order for the final product to emerge and become a workable system. The number...hall’s stage carrying a guitar case with a shotgun in it and three handguns 83 MABAS-Illinois, “What

  1. Guidelines for Mass Casualty Decontamination During a HAZMAT/Weapon of Mass Destruction Incident. Volumes 1 and 2

    Science.gov (United States)

    2009-04-01

    of maintaining and producing heat: resting (quiescent body state) metabolism, exercise , and shivering (the involuntary contraction of muscles ...agencies during response exercises include Tyvek® suits, blankets, sheets and large plastic garbage bags. Tag Victims to Identify Decontamination Status...agents are immediate and observable and range from spasms and vomiting to dizziness, disorientation and death. Because effects are determined by dosage

  2. Personal factors affecting ethical performance in healthcare workers during disasters and mass casualty incidents in Iran: a qualitative study.

    Science.gov (United States)

    Kiani, Mehrzad; Fadavi, Mohsen; Khankeh, Hamidreza; Borhani, Fariba

    2017-02-20

    In emergencies and disasters, ethics are affected by both personal and organizational factors. Given the lack of organizational ethical guidelines in the disaster management system in Iran, the present study was conducted to explain the personal factors affecting ethics and ethical behaviors among disaster healthcare workers. The present qualitative inquiry was conducted using conventional content analysis to analyze the data collected from 21 in-depth unstructured interviews with healthcare workers with an experience of attending one or more fields of disaster. According to the data collected, personal factors can be classified into five major categories, including personal characteristics such as age and gender, personal values, threshold of tolerance, personal knowledge and reflective thinking. Without ethical guidelines, healthcare workers are intensely affected by the emotional climate of the event and guided by their beliefs. A combination of personal characteristics, competences and expertise thus form the basis of ethical conduct in disaster healthcare workers.

  3. Air MEDEVAC in case of multiple casualties – The experience of civilian-military cooperation in RoAF

    Directory of Open Access Journals (Sweden)

    Dragoș C. Tudose

    2016-07-01

    Full Text Available Introduction: Starting September 2010 in Romania was created the Military Emergency Medical Service (SMMU by the Ministry of National Defense, which has as main mission to provide first aid and save the lives of military personnel during military operations using special equipped MEDEAVC aircraft. Nationwide exist the national emergency system which operates thru 112- SMURD acting in support of the civilian population. In case of accidents with multiple victims the experience has shown the need for collaboration between the two systems, in order to save lives. In the last 5 years there has been an increasing Airlift missions (MEDEVAC with multiple victims executed by joint civil-military medical teams using military aircraft. Material and methods. This paper provides a review of the most important aspects of particularities, advantages and disadvantages of this type of medical transport using the MEDEVAC missions based study carried out by the Air Force in recent years. Results and conclusions. Performing these tasks presents challenges to mission planning, use of medical equipment and procedures, command-control system, exercise programs jointly joint medical teams and, of course, managing a large number of patients in flight. The large number of patients transported safely and in the shortest time, regardless of weather conditions recommends this type of medical intervention. Given the Romanian military presence in various theaters and that NATO strategic medical evacuation is a national responsibility, the capacity of air transport in case multiple casualties is a priority.

  4. Provenancing of unidentified World War II casualties: Application of strontium and oxygen isotope analysis in tooth enamel.

    Science.gov (United States)

    Font, Laura; Jonker, Geert; van Aalderen, Patric A; Schiltmans, Els F; Davies, Gareth R

    2015-01-01

    In 2010 and 2012 two sets of unidentified human remains of two World War II soldiers were recovered in the area where the 1944-1945 Kapelsche Veer bridgehead battle took place in The Netherlands. Soldiers of four Allied nations: British Royal Marine Commandos, Free Norwegian Commandos, Free Poles and Canadians, fought against the German Army in this battle. The identification of these two casualties could not be achieved using dental record information of DNA analysis. The dental records of Missing in Action soldiers of the Allied nations did not match with the dental records of the two casualties. A DNA profile was determined for the casualty found in 2010, but no match was found. Due to the lack of information on the identification of the casualties provided by routine methods, an isotope study was conducted in teeth from the soldiers to constrain their provenance. The isotope study concluded that the tooth enamel isotope composition for both casualties matched with an origin from the United Kingdom. For one of the casualties a probable origin from the United Kingdom was confirmed, after the isotope study was conducted, by the recognition of a characteristic belt buckle derived from a Royal Marine money belt, only issued to British Royal Marines, found with the remains of the soldier.

  5. Psychological casualties resulting from chemical and biological weapons.

    Science.gov (United States)

    Romano, J A; King, J M

    2001-12-01

    This symposium addresses the complications encountered by medical planners when confronted by the use or threat of the use of weapons of mass destruction. The types of chemical warfare agents (CWA), their principal target organs, and physiological effects are discussed. We have reviewed the use of CWA in 20th century warfare and otherwise with emphasis on five cases: (1) use of sulfur mustard during World War I; (2) use by Italy against Ethiopia; (3) use in the Sino-Japanese War; (4) relatively well-studied use in the Iran-Iraq conflict; and (5) the use of sarin in the Tokyo subway terrorist incident. We reviewed the additional physiological and psychological consequences of their use and threat of use. Results from training and simulation are discussed. Finally, we present our conclusions derived from the analysis of these historical situations.

  6. Frequency and Relevance of Acute Peritraumatic Pulmonary Thrombus Diagnosed by Computed Tomographic Imaging in Combat Casualties

    Science.gov (United States)

    2013-08-01

    determine the prevalence of and risk factors for the diagnosis of APPT in casualties admitted to Bastion Hospital, Afghanistan. APPT imaging characteristics...were collected, and demographics, injury severity and mechanism, and risk factors were included in the analysis. Logistic regression was used to...segmental, and 15% (n = 10) were subsegmental. Forty-seven percent (n = 31) had bilateral APPT. Logistic regression found presence of deep venous thrombosis

  7. The Impacts of Air Temperature on Accidental Casualties in Beijing, China

    Science.gov (United States)

    Ma, Pan; Wang, Shigong; Fan, Xingang; Li, Tanshi

    2016-01-01

    Emergency room (ER) visits for accidental casualties, according to the International Classification of Deceases 10th Revision Chapters 19 and 20, include injury, poisoning, and external causes (IPEC). Annual distribution of 187,008 ER visits that took place between 2009 and 2011 in Beijing, China displayed regularity rather than random characteristics. The annual cycle from the Fourier series fitting of the number of ER visits was found to explain 63.2% of its total variance. In this study, the possible effect and regulation of meteorological conditions on these ER visits are investigated through the use of correlation analysis, as well as statistical modeling by using the Distributed Lag Non-linear Model and Generalized Additive Model. Correlation analysis indicated that meteorological variables that positively correlated with temperature have a positive relationship with the number of ER visits, and vice versa. The temperature metrics of maximum, minimum, and mean temperatures were found to have similar overall impacts, including both the direct impact on human mental/physical conditions and indirect impact on human behavior. The lag analysis indicated that the overall impacts of temperatures higher than the 50th percentile on ER visits occur immediately, whereas low temperatures show protective effects in the first few days. Accidental casualties happen more frequently on warm days when the mean temperature is higher than 14 °C than on cold days. Mean temperatures of around 26 °C result in the greatest possibility of ER visits for accidental casualties. In addition, males were found to face a higher risk of accidental casualties than females at high temperatures. Therefore, the IPEC-classified ER visits are not pure accidents; instead, they are associated closely with meteorological conditions, especially temperature. PMID:27827842

  8. The Impacts of Air Temperature on Accidental Casualties in Beijing, China

    Directory of Open Access Journals (Sweden)

    Pan Ma

    2016-11-01

    Full Text Available Emergency room (ER visits for accidental casualties, according to the International Classification of Deceases 10th Revision Chapters 19 and 20, include injury, poisoning, and external causes (IPEC. Annual distribution of 187,008 ER visits that took place between 2009 and 2011 in Beijing, China displayed regularity rather than random characteristics. The annual cycle from the Fourier series fitting of the number of ER visits was found to explain 63.2% of its total variance. In this study, the possible effect and regulation of meteorological conditions on these ER visits are investigated through the use of correlation analysis, as well as statistical modeling by using the Distributed Lag Non-linear Model and Generalized Additive Model. Correlation analysis indicated that meteorological variables that positively correlated with temperature have a positive relationship with the number of ER visits, and vice versa. The temperature metrics of maximum, minimum, and mean temperatures were found to have similar overall impacts, including both the direct impact on human mental/physical conditions and indirect impact on human behavior. The lag analysis indicated that the overall impacts of temperatures higher than the 50th percentile on ER visits occur immediately, whereas low temperatures show protective effects in the first few days. Accidental casualties happen more frequently on warm days when the mean temperature is higher than 14 °C than on cold days. Mean temperatures of around 26 °C result in the greatest possibility of ER visits for accidental casualties. In addition, males were found to face a higher risk of accidental casualties than females at high temperatures. Therefore, the IPEC-classified ER visits are not pure accidents; instead, they are associated closely with meteorological conditions, especially temperature.

  9. The Impact of 10 Years of War on Combat Casualty Care Research: A Citation Analysis

    Science.gov (United States)

    2012-01-01

    METHODS The Thompson Reuters Web of Science was queried in October 2011 for articles published between 2001 and 2011, the first 10 years of the current...within Web of Science , we limited the selected articles to those within the fol- lowing subject areas of highest relevance to combat casualty care...accessed using the Web of Science database to obtain information about the number of article citations. A final review of the top 50 most frequently

  10. Computer Simulation for Emergency Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Brown, D L

    2004-12-03

    This report describes the findings and recommendations resulting from the Department of Homeland Security (DHS) Incident Management Simulation Workshop held by the DHS Advanced Scientific Computing Program in May 2004. This workshop brought senior representatives of the emergency response and incident-management communities together with modeling and simulation technologists from Department of Energy laboratories. The workshop provided an opportunity for incident responders to describe the nature and substance of the primary personnel roles in an incident response, to identify current and anticipated roles of modeling and simulation in support of incident response, and to begin a dialog between the incident response and simulation technology communities that will guide and inform planned modeling and simulation development for incident response. This report provides a summary of the discussions at the workshop as well as a summary of simulation capabilities that are relevant to incident-management training, and recommendations for the use of simulation in both incident management and in incident management training, based on the discussions at the workshop. In addition, the report discusses areas where further research and development will be required to support future needs in this area.

  11. Investigating the Relationship Between Drone Warfare and Civilian Casualties in Gaza

    Directory of Open Access Journals (Sweden)

    Dr. Ann Rogers

    2014-12-01

    Full Text Available Unmanned aerial vehicles (UAVs, better known as drones, are increasingly touted as ‘humanitarian’ weapons that contribute positively to fighting just wars and saving innocent lives. At the same time, civilian casualties have become the most visible and criticized aspect of drone warfare. It is argued here that drones contribute to civilian casualties not in spite of, but because of, their unique attributes. They greatly extend war across time and space, pulling more potential threats and targets into play over long periods, and because they are low-risk and highly accurate, they are more likely to be used. The assumption that drones save lives obscures a new turn in strategic thinking that sees states such as Israel and the US rely on large numbers of small, highly discriminating attacks applied over time to achieve their objectives. This examination of Israel’s 2014 war in Gaza argues that civilian casualties are not an unexpected or unintended consequence of drone warfare, but an entirely predictable outcome.

  12. Operationalizing Civilian Protection in Mali: The Case for a Civilian Casualty Tracking, Analysis, and Response Cell

    Directory of Open Access Journals (Sweden)

    Marla B. Keenan

    2013-06-01

    Full Text Available This practice note details an emerging best practice of civilian harm mitigation in armed conflict: namely, the creation of civilian casualty tracking, analysis and response processes by a warring party or peace operation force. It asserts that in Iraq, Afghanistan and soon Somalia, these processes to better understand civilian harm and address consequences have positively shaped mission tactics, training, and overall operations. In both Iraq and Afghanistan, tracking and analysis has lead to a marked decrease in civilian casualties and facilitated the making of amends for any civilian losses. The paper argues that for warring parties to achieve their mission—particularly one with a protection of civilians mandate as with the United Nations Multidimensional Integrated Stabilization Mission in Mali (MINUSMA—they must fully understand the impact of their actions on the civilian population, positive or negative. For this reason, a Civilian Casualty Tracking, Analysis, and Response Cell should be created for MINUSMA to improve its ability mitigate risk to civilians as required by its Security Council mandate.

  13. [NATO international advanced course on best way of training for mass casualty situations].

    Science.gov (United States)

    Klein, L; Michaelson, M

    2010-07-01

    NATO Advanced Training Course on Best Way of Training for Mass Casualty Situations was held in Haifa, Israel in November 16-18, 2009. In total, 22 participants from 8 countries of the Partnership for Peace and Mediterranean Dialogue Programmes attended the course. The participants, divided within three groups, discussed and practised the training methods for the preshospital aspect, the hospital aspect and the non-conventional aspect of the mass casualty management. An international team of experts, among others, used following teaching methods: general lectures, guided discussions, utilization of advanced multimedia tools, tabletop drills, and large scale drill as training tools. The trainees also learned about medical and clinical simulation as a training tool, and subsequently practiced it. A mass casualty drill was held in Rambam Health Care Campus at the end of the Course. The trainees of the course participated as observers and reviewers in the drill, and debriefed it together with Rambam medical staff. Realisation of the successful course was made possible by utilizing a grant of the NATO Science for Peace and Security Programme.

  14. Critical incident reporting systems.

    Science.gov (United States)

    Ahluwalia, Jag; Marriott, Lin

    2005-02-01

    Approximately 10% of all hospital admissions are complicated by critical incidents in which harm is caused to the patient - this amounts to more than 850,000 incidents annually. Critical incident reporting (CIR) systems refer to the structured reporting, collation and analysis of such incidents. This article describes the attributes required for an effective CIR system. Example neonatal trigger events and a management pathway for handling a critical incident report are described. The benefits and limitations of CIR systems, reactive and prospective approaches to the analysis of actual or potential critical incidents and the assessment of risk are also reviewed. Individual human error is but one contributor in the majority of critical incidents. Recognition of this and the fostering of an organisational culture that views critical incident reports as an opportunity to learn and to improve future patient care is vital if CIR systems are to be effective.

  15. General Urban Warfare Amphibious Logistics Applications. Volume 3. Operational Plans.

    Science.gov (United States)

    1983-06-23

    cite the following field dental support missions: general dentistry support, care of maxillofacial injuries , assistance with the initial treatment of...on the treatment of maxillofacial injuries (MFI) and the assistance provided in the care of non-MFI casualties. Dental support was ship-based at the...accomplish the general dentistry workload. V-106 * ..*.* -. . * -*..The incidence of maxillofacial injuries (MFI) among WIA during the Korean and

  16. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir

    2015-01-01

    Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

  17. [The academic education in nursing and multiple-victim incidents: an integrative review].

    Science.gov (United States)

    Salvador, Pétala Tuani Candido de Oliveira; Dantas, Rodrigo Assis Neves; Dantas, Daniele Vieira; Torres, Gilson de Vasconcelos

    2012-06-01

    The objective of this study is to reflect on the knowledge, competencies and skill that must be promoted during the academic education of nurses for an effective professional practice in view of a multiple-victim incident (MVI). This is an integrative literature review regarding academic nursing education. The literature survey was performed on the BDENF, LILACS, SciELO, MEDLINE, Web of Knowledge and HighWire Press databases, using the following descriptors: higher education; nursing education; emergency nursing; and mass casualty incidents. The publications permitted considerations regarding the following themes: particularities; competencies and skills essential in nursing practice in view of multiple-victim incidents; and the professors' strategies to promote those competencies and skills. The literature analysis demonstrated that nursing education should be configured as a space to develop critical thinking skills, which requires professors to have an eclectic educational background.

  18. Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents

    Directory of Open Access Journals (Sweden)

    GS DeFraia

    2015-07-01

    Full Text Available Background: Psychologically traumatic workplace events (known as critical incidents occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions.Objective: To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents.Methods: Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events.Results: Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident.Conclusion: Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

  19. Sociological Features of the Casualties from the 1996 Ms 7. 0 Lijiang Earthquake, Yunnan Province

    Institute of Scientific and Technical Information of China (English)

    Li Yongqiang; Yang Jieying; Yang Dongsheng

    2012-01-01

    A statistics analysis was conducted on the basic information about fatalities from the Lijiang Ms 7.0 earthquake in 1996. The factors include age, gender, educational background, occupation, cause of death, death place, etc. We found that even though deaths caused by the Lijiang earthquake had some common features with those from earthquakes in other places in China, it also showed some specific features because of the multiracial and economically-underdeveloped situation of Lijiang area. The results reached in the paper can serve as a reference for studying the features of casualties caused by future strong earthquakes in Yunnan, and for the delicate and human-oriented emergency treatment.

  20. Casualty Searching, Evacuation and Telemedicine System Based on BeiDou Navigation Satellite System%基于北斗卫星定位的伤员搜救与后送、远程医疗系统

    Institute of Scientific and Technical Information of China (English)

    邬小军; 汪陈应; 刘志; 李学成; 赵军平

    2011-01-01

    Objective To develop a casualty searching, evacuation and telemedicine system to make the soldiers accompanied by medical support. Methods Based on telemedicine technology and locating & two-way communication ability of BeiDou Navigation Satellite System, the hierarchy of the system was designed. Remits The design plan of the casualty searching, evacuation and telemedicine system based on BeiDou Navigation Satellite System was put forward. Conclusion The Casualty precision location, rescue and evacuation are realized for medical support of military operationsother than war.[Chinese Medical Equipment Journal,2011,32(12):9-12]%目的:研制适合于一线救护的伤员搜救与后送、远程医疗系统,最大限度地实现医疗与士兵同在.方法:立足军队现有远程医疗技术,利用北斗卫星同时具备定位与双向通信的能力,设计一整套伤员搜寻、后送与远程医疗体系架构.结果:构建了基于北斗卫星定位的伤员搜救、后送与远程医疗平台设计方案.结论:解决了战场伤员精确定位、援救与后送的难题,满足了非战争军事行动卫勤保障的需要.

  1. Stephanie Clark: From Teaching Incident to Case.

    Science.gov (United States)

    Silverman, Rita; Welty, William M.

    1996-01-01

    Steps taken by instructional designers in constructing a case study for use in faculty development are outlined, from the original case study idea to selection of an appropriate classroom incident, writing the case, and planning the teaching process (identifying relevant issues, preparing discussion questions, and organizing discussion). The text…

  2. The Vulnerability of People to Landslides: A Case Study on the Relationship between the Casualties and Volume of Landslides in China.

    Science.gov (United States)

    Lin, Qigen; Wang, Ying; Liu, Tianxue; Zhu, Yingqi; Sui, Qi

    2017-02-21

    The lack of a detailed landslide inventory makes research on the vulnerability of people to landslides highly limited. In this paper, the authors collect information on the landslides that have caused casualties in China, and established the Landslides Casualties Inventory of China. 100 landslide cases from 2003 to 2012 were utilized to develop an empirical relationship between the volume of a landslide event and the casualties caused by the occurrence of the event. The error bars were used to describe the uncertainty of casualties resulting from landslides and to establish a threshold curve of casualties caused by landslides in China. The threshold curve was then applied to the landslide cases occurred in 2013 and 2014. The validation results show that the estimated casualties of the threshold curve were in good agreement with the real casualties with a small deviation. Therefore, the threshold curve can be used for estimating potential casualties and landslide vulnerability, which is meaningful for emergency rescue operations after landslides occurred and for risk assessment research.

  3. Comparison of Acinetobacter baumannii isolates from the United Kingdom and the United States that were associated with repatriated casualties of the Iraq conflict.

    Science.gov (United States)

    Turton, Jane F; Kaufmann, Mary E; Gill, Martin J; Pike, Rachel; Scott, Paul T; Fishbain, Joel; Craft, David; Deye, Gregory; Riddell, Scott; Lindler, Luther E; Pitt, Tyrone L

    2006-07-01

    Acinetobacter isolates associated with casualties from the Iraq conflict from the United States were compared with those from the United Kingdom by pulsed-field gel electrophoresis and integron analysis. Representatives of the main outbreak strain associated with casualties from both countries were indistinguishable in DNA profile. Two further outbreak strains were common to both sets of isolates.

  4. Cancer incidence among waiters

    DEFF Research Database (Denmark)

    Reijula, Jere; Kjaerheim, Kristina; Lynge, Elsebeth

    2015-01-01

    INCIDENCE IN SOME CANCER SITES CAN LIKELY BE EXPLAINED BY HIGHER ALCOHOL CONSUMPTION, THE PREVALENCE OF SMOKING AND OCCUPATIONAL EXPOSURE TO TOBACCO SMOKE HOPEFULLY, THE INCIDENCE OF CANCER AMONG WAITERS WILL DECREASE IN THE FUTURE, DUE TO THE BANNING OF TOBACCO SMOKING IN RESTAURANTS AND BARS IN THE NORDIC...

  5. Recce mission planning

    Science.gov (United States)

    York, Andrew M.

    2000-11-01

    The ever increasing sophistication of reconnaissance sensors reinforces the importance of timely, accurate, and equally sophisticated mission planning capabilities. Precision targeting and zero-tolerance for collateral damage and civilian casualties, stress the need for accuracy and timeliness. Recent events have highlighted the need for improvement in current planning procedures and systems. Annotating printed maps takes time and does not allow flexibility for rapid changes required in today's conflicts. We must give aircrew the ability to accurately navigate their aircraft to an area of interest, correctly position the sensor to obtain the required sensor coverage, adapt missions as required, and ensure mission success. The growth in automated mission planning system capability and the expansion of those systems to include dedicated and integrated reconnaissance modules, helps to overcome current limitations. Mission planning systems, coupled with extensive integrated visualization capabilities, allow aircrew to not only plan accurately and quickly, but know precisely when they will locate the target and visualize what the sensor will see during its operation. This paper will provide a broad overview of the current capabilities and describe how automated mission planning and visualization systems can improve and enhance the reconnaissance planning process and contribute to mission success. Think about the ultimate objective of the reconnaissance mission as we consider areas that technology can offer improvement. As we briefly review the fundamentals, remember where and how TAC RECCE systems will be used. Try to put yourself in the mindset of those who are on the front lines, working long hours at increasingly demanding tasks, trying to become familiar with new operating areas and equipment, while striving to minimize risk and optimize mission success. Technical advancements that can reduce the TAC RECCE timeline, simplify operations and instill Warfighter

  6. Development of Mass-casualty Life Support-CBRNE (MCLS-CBRNE) in Japan.

    Science.gov (United States)

    Anan, Hideaki; Otomo, Yasuhiro; Kondo, Hisayoshi; Homma, Masato; Koido, Yuichi; Morino, Kazuma; Oshiro, Kenichi; Harikae, Kiyokazu; Akasaka, Osamu

    2016-10-01

    This report outlines the need for the development of an advanced course in mass-casualty life support (MCLS) and introduces the course content. The current problems with education on disasters involving chemical agents, biological agents, radiation/nuclear attacks, or explosives (CBRNE) in Japan are presented. This newly developed "MCLS-CBRNE" program was created by a Ministry of Health, Labour, and Welfare (Tokyo, Japan) research group based on these circumstances. Modifications were then made after a trial course. Training opportunities for relevant organizations to learn how to act at a CBRNE disaster site currently are lacking. The developed course covers initial responses at a disaster site. This one-day training course comprises lectures, three tabletop simulations, and practical exercises in pre-decontamination triage and post-decontamination triage. With regard to field exercises conducted to date, related organizations have experienced difficulties in understanding each other and adapting their approaches. Tabletop simulations provide an opportunity for participants to learn how organizations working on-site, including fire, police, and medical personnel, act with differing goals and guiding principles. This course appears useful as a means for relevant organizations to understand the importance of developing common guidelines. The MCLS-CBRNE training is proposed to support CBRNE disaster control measures during future events. Anan H , Otomo Y , Kondo H , Homma M , Koido Y , Morino K , Oshiro K , Harikae K , Akasaka O . Development of mass-casualty life support-CBRNE (MCLS-CBRNE) in Japan. Prehosp Disaster Med. 2016;31(5):547-550.

  7. Using the Design for Demise Philosophy to Reduce Casualty Risk Due to Reentering Spacecraft

    Science.gov (United States)

    Kelley, R. L.

    2012-01-01

    Recently the reentry of a number of vehicles has garnered public attention due to their risk of human casualty due to fragments surviving reentry. In order to minimize this risk for their vehicles, a number of NASA programs have actively sought to minimize the number of components likely to survive reentry at the end of their spacecraft's life in order to meet and/or exceed NASA safety standards for controlled and uncontrolled reentering vehicles. This philosophy, referred to as "Design for Demise" or D4D, has steadily been adopted, to at least some degree, by numerous programs. The result is that many programs are requesting evaluations of components at the early stages of vehicle design, as they strive to find ways to reduce the number surviving components while ensuring that the components meet the performance requirements of their mission. This paper will discuss some of the methods that have been employed to ensure that the consequences of the vehicle s end-of-life are considered at the beginning of the design process. In addition this paper will discuss the technical challenges overcome, as well as some of the more creative solutions which have been utilized to reduce casualty risk.

  8. Study of the Model of Activating Contingency Plans within Disruptive Incidents by Stages%突发事件下分阶段启动应急预案模型研究

    Institute of Scientific and Technical Information of China (English)

    于辉; 江智慧

    2011-01-01

    经前期处置下,研究管理者面对突发事件应该何时启动前期处置方案和应急预案的问题.在完全没有突发事件持续时阎信息的条件下,利用局内决策理论与方法构建了企业何时启动前期处置方案和应急预案的分阶段启动模型,并利用"竞争比"说明该方案的有效性.在此基础上,进一步通过数值分析表明分阶段启动应急预案的重要意义.%The increased number of natural disasters has disrupted social and economic progress. Minimizing the impact of these disasters can bring stability to society. Emergency response systems have played an important role in achieving this goal. Since the "SARS" crisis in the year 2003, China has begun to focus on building emergency response systems. A national contingency plan system was established in 2004 according to the "Classification" rule. China initially formed a main emergency plan system,constituted by national overall emergency response plans, specific contingency plans, department emergency plans, local emergency plans, and contingency plans for enterprises with large-scale activities.Existing literature has focused on the importance of contingency plans, the assessment of contingency plans, and approaches to improving emergency preparedness. Few studies have addressed problems associated with the activation of contingency plans when the public administration is disrupted by natural disasters. This paper investigates how managers activate contingency plans at the predisposal stage and potential problems that may arise from disruption by natural disasters at this stage. Case studies are conducted and our analysis results show that activating contingency plans at the pre-disposition stage is effective at dealing with public crises caused by natural disasters. A mathematical model is constructed to provide information on when to activate contingency plans in different phases.Decision theories and methods are used to help propose an

  9. Drug related critical incidents.

    Science.gov (United States)

    Khan, F A; Hoda, M Q

    2005-01-01

    Drug related incidents are a common form of reported medical errors. This paper reviews the critical incidents related to drug errors reported from the main operating theatre suite in a teaching hospital in a developing country from January 1997 to December 2002. Each report was evaluated individually by two reviewers using a structured process. During this period, 44 874 anaesthetics were administered; 768 critical incidents were reported, 165 (21%) of which were related to drug errors. Underdosage, side-effect/drug reaction and syringe swap were the most common. A total of 76% were classified as preventable; 56% due to human error and 19% due to system error. High risk incidents accounted for 10% of all drug errors and most of these were related to the use of neuromuscular blocking drugs. This analysis has been found useful in addressing some issues about priorities.

  10. Large whale incident database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Large whale stranding, death, ship strike and entanglement incidents are all recorded to monitor the health of each population and track anthropogenic factors that...

  11. Police Incident Blotter (Archive)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Police Blotter Archive contains crime incident data after it has been validated and processed to meet Uniform Crime Reporting (UCR) standards, published on a...

  12. 33 CFR 150.820 - When must a written report of casualty be submitted, and what must it contain?

    Science.gov (United States)

    2010-07-01

    ... must also include the information relating to alcohol and drug involvement specified by 46 CFR 4.05-12... CFR part 16. (c) If filed immediately after the event, the written report required by paragraph (a) of... casualty be submitted, and what must it contain? 150.820 Section 150.820 Navigation and Navigable...

  13. Cyanide antidotes for mass casualties: water-soluble salts of the dithiane (sulfanegen) from 3-mercaptopyruvate for intramuscular administration.

    Science.gov (United States)

    Patterson, Steven E; Monteil, Alexandre R; Cohen, Jonathan F; Crankshaw, Daune L; Vince, Robert; Nagasawa, Herbert T

    2013-02-14

    Current cyanide antidotes are administered by IV infusion, which is suboptimal for mass casualties. Therefore, in a cyanide disaster, intramuscular (IM) injectable antidotes would be more appropriate. We report the discovery of the highly water-soluble sulfanegen triethanolamine as a promising lead for development as an IM injectable cyanide antidote.

  14. Shipboard and Ground Troop Casualty Rates among Navy and Marine Corps Personnel during World War II Operations

    Science.gov (United States)

    1990-08-01

    range of ships (major combatants, patrol craft, submarines, minecraft , landing craft, auxiliary vessels) critical to successful naval engagements. Figure... minecraft , and patrol craft. These vessels are generally small, with minrimnl rrpw rcmn1pmpntf. vieldina high rates of casualties when hit. Fuel oil

  15. Casualty Aversion in the Post-Cold War Era: Defined and Analyzed Through the Logic of Clausewitz

    Science.gov (United States)

    2007-11-02

    faced with risk and self sacrifice. The paper gives few answers, but raises many questions. Suro , Roberto, “Zeroing In on “Zero Casualty Syndrome...leaders have denied themselves the ability to maneuver and thus surprise the enemy. Mr. Suro takes this thought and applies it to President Clinton

  16. Slope Failure Prediction and Early Warning Awareness Education for Reducing Landslides Casualty in Malaysia

    Science.gov (United States)

    Koay, S. P.; Tay, L. T.; Fukuoka, H.; Koyama, T.; Sakai, N.; Jamaludin, S. B.; Lateh, H.

    2015-12-01

    Northeast monsoon causes heavy rain in east coast of Peninsular Malaysia from November to March, every year. During this monsoon period, besides the happening of flood along east coast, landslides also causes millions of Malaysian Ringgit economical losses. Hence, it is essential to study the prediction of slope failure to prevent the casualty of landslides happening. In our study, we introduce prediction method of the accumulated rainfall affecting the stability of the slope. If the curve, in the graph, which is presented by rainfall intensity versus accumulated rainfall, crosses over the critical line, the condition of the slope is considered in high risk where the data are calculated and sent from rain gauge in the site via internet. If the possibility of slope failure is going high, the alert message will be sent out to the authorities for decision making on road block or setting the warning light at the road side. Besides road block and warning light, we propose to disseminate short message, to pre-registered mobile phone user, to notify the public for easing the traffic jam and avoiding unnecessary public panic. Prediction is not enough to prevent the casualty. Early warning awareness of the public is very important to reduce the casualty of landslides happening. IT technology does not only play a main role in disseminating information, early warning awareness education, by using IT technology, should be conducted, in schools, to give early warning awareness on natural hazard since childhood. Knowing the pass history on landslides occurrence will gain experience on the landslides happening. Landslides historical events with coordinate information are stored in database. The public can browse these historical events via internet. By referring to such historical landslides events, the public may know where did landslides happen before and the possibility of slope failure occurrence again is considered high. Simulation of rainfall induced slope failure mechanism

  17. Spatial-temporal patterns in Mediterranean carnivore road casualties: Consequences for mitigation

    Science.gov (United States)

    Grilo, C.; Bissonette, J.A.; Santos-Reis, M.

    2009-01-01

    Many carnivores have been seriously impacted by the expansion of transportation systems and networks; however we know little about carnivore response to the extent and magnitude of road mortality, or which age classes may be disproportionately impacted. Recent research has demonstrated that wildlife-vehicle-collisions (WVC) involving carnivores are modulated by temporal and spatial factors. Thus, we investigated road mortality on a guild of small and medium-sized carnivores in southern Portugal using road-kill data obtained from a systematic 36 months monitoring period along highways (260 km) and national roads (314 km) by addressing the following questions: (a) which species and age class are most vulnerable to WVC? (b) are there temporal and/or spatial patterns in road-kill? and (c) which life-history and/or spatial factors influence the likelihood of collisions? We recorded a total of 806 carnivore casualties, which represented an average of 47 ind./100 km/year. Red fox and stone marten had the highest mortality rates. Our findings highlight three key messages: (1) the majority of road-killed individuals were adults of common species; (2) all carnivores, except genets, were more vulnerable during specific life-history phenological periods: higher casualties were observed when red fox and stone marten were provisioning young, Eurasian badger casualties occurred more frequently during dispersal, and higher Egyptian mongoose mortality occurred during the breeding period; and (3) modeling demonstrated that favorable habitat, curves in the road, and low human disturbance were major contributors to the deadliest road segments. Red fox carcasses were more likely to be found on road sections with passages distant from urban areas. Conversely, stone marten mortalities were found more often on national roads with high of cork oak woodland cover; Egyptian mongoose and genet road-kills were found more often on road segments close to curves. Based on our results, two key

  18. Long-term disabilities associated with combat casualties: measuring disability and reintegration in combat veterans.

    Science.gov (United States)

    Resnik, Linda; Reiber, Gayle

    2012-01-01

    Many physical and mental health problems associated with combat casualties affect the reintegration of service members into home and community life. Quantifying and measuring reintegration is important to answer questions about clinical, research, economic, and policy issues that directly affect combat veterans. Although the construct of participation presented in the International Statistical Classification of Diseases and Related Health Problems and in the International Classification of Functioning, Disability and Health provides a theoretical framework with which to understand and measure community reintegration in general, a measure was needed that specifically addressed the reintegration of combat veterans. To address this need, the Community Reintegration for Service Members global outcomes measure was developed. It consists of three scales, which measure extent of participation, perceived limitations, and satisfaction. The measure was validated in a general sample of veterans and in a sample of severely wounded service members. The computer-adapted test version shows good precision, reliability, construct validity, and predictive validity.

  19. Loss of cabin pressure in a military transport: a mass casualty with decompression illnesses.

    Science.gov (United States)

    Johnston, Mickaila J

    2008-04-01

    Presented here is the sudden cabin depressurization of a military C-130 aircraft carrying 66 personnel. They suffered a depressurization from 2134 to 7317 m, resulting in a potential 66-person mass casualty. The aircrew were able to descend to below 3049 m in less than 5 min. They landed in the Kingdom of Bahrain--the nearest hyperbaric recompression facility. Three cases of peripheral neurologic DCS and one case of spinal DCS were identified. Limited manning, unique host nation concerns, and limited available assets led to difficulties in triage, patient transport, and asset allocation. These led to difficult decisions regarding when and for whom to initiate ground level oxygen or hyperbaric recompression therapy.

  20. Radiation incidents in dentistry

    Energy Technology Data Exchange (ETDEWEB)

    Lovelock, D.J. [Dental Hospital and School, Newcastle upon Tyne (United Kingdom). Dept. of Radiology

    1996-12-31

    Most dental practitioners act as their own radiographer and radiologist, unlike their medical colleagues. Virtually all dental surgeons have a dental X-ray machine for intraoral radiography available to them and 40% of dental practices have equipment for dental panoramic tomography. Because of the low energy of X-ray equipment used in dentistry, radiation incidents tend to be less serious than those associated with other aspects of patient care. Details of 47 known incidents are given. The advent of the 1985 and 1988 Ionising Radiation Regulations has made dental surgeons more aware of the hazards of radiation. These regulations, and general health and safety legislation, have led to a few dental surgeons facing legal action. Because of the publicity associated with these court cases, it is expected that there will be a decrease in radiation incidents arising from the practice of dentistry. (author).

  1. [Terrorists' target World Cup 2006: disaster medicine on the sidelines?! Aspects of hospital disaster planning].

    Science.gov (United States)

    Weidringer, J W; Ansorg, J; Ulrich, B C; Polonius, M-J; Domres, B D

    2004-09-01

    Focussing on possible mass casualty situations during events such as the soccer world championship in 2006, the Professional Board of Surgeons in Germany and the German Society for Surgery canvassed surgeons-in-chief in the last quarter of 2003 concerning disaster plans for hospitals. The rate of returned questionnaires amounted to 26% covering the following areas of interest: plans-ready to use, known by the employees as well as by the rescue coordination center, performance of exercises, and concepts on decontamination and detoxification. Based on past numbers of casualties during soccer disasters, an excursus into details also includes a description of an approach to reduce the danger of bottleneck effects at doors. A preliminary concept based on the upcoming system for funding hospitals in Germany and including new partnerships is outlined, succeeded by some hopefully helpful hints for a web-based hospital disaster plan.

  2. Lightning incidents in Mongolia

    Directory of Open Access Journals (Sweden)

    Myagmar Doljinsuren

    2015-11-01

    Full Text Available This is one of the first studies that has been conducted in Mongolia on the distribution of lightning incidents. The study covers a 10-year period from 2004 to 2013. The country records a human death rate of 15.4 deaths per 10 million people per year, which is much higher than that of many countries with similar isokeraunic level. The reason may be the low-grown vegetation observed in most rural areas of Mongolia, a surface topography, typical to steppe climate. We suggest modifications to Gomes–Kadir equation for such countries, as it predicts a much lower annual death rate for Mongolia. The lightning incidents spread over the period from May to August with the peak of the number of incidents occurring in July. The worst lightning affected region in the country is the central part. Compared with impacts of other convective disasters such as squalls, thunderstorms and hail, lightning stands as the second highest in the number of incidents, human deaths and animal deaths. Economic losses due to lightning is only about 1% of the total losses due to the four extreme weather phenomena. However, unless precautionary measures are not promoted among the public, this figure of losses may significantly increase with time as the country is undergoing rapid industrialization at present.

  3. VOYAGE PLANNING

    Directory of Open Access Journals (Sweden)

    Kazimierz SKÓRA

    2016-09-01

    Full Text Available A sea voyage can be divided into three parts with varying degrees of risk: - from the berth at the port of departure to the pilot disembarkation point - from the pilot disembarkation to another pilot embarkation point near the port of call/destination - from the pilot embarkation point to the berth Results of statistical research into ship accidents at sea point to an increased number of incidents and accidents, including groundings, especially in restricted areas. Such areas are often narrow and have limited depths, while their short straight sections require frequent course alterations, often in varying hydrometeorological conditions. Due to all these factors, the voyage has to be carefully planned and all watchkeeping officers have to be well prepared to conduct the ship safely. The article presents the objectives, scope, legal basis and stages in the process of voyage planning. The compliance with the outlined principles will reduce the level of risk in maritime transport.

  4. An Air MEDEVAC Asset Dispatching and Prioritized Casualty Transporting Model for Military Medical Evacuation Systems with Distinguishable Medical Treatment Facilities and Errors in Triage

    Science.gov (United States)

    2014-02-13

    distinguishable medical treatment facilities and errors in triage The views, opinions and/or findings contained in this report are those of the author(s) and...facilities and errors in triage Report Title Decision making in military medical evacuation (MEDEVAC) of casualties consists of identifying which...treatment facilities. The model accounts for errors made during triage of casualties to investigate the revelation of information over time and

  5. Quantifying the causal effects of 20mph zones on road casualties in London via doubly robust estimation.

    Science.gov (United States)

    Li, Haojie; Graham, Daniel J

    2016-08-01

    This paper estimates the causal effect of 20mph zones on road casualties in London. Potential confounders in the key relationship of interest are included within outcome regression and propensity score models, and the models are then combined to form a doubly robust estimator. A total of 234 treated zones and 2844 potential control zones are included in the data sample. The propensity score model is used to select a viable control group which has common support in the covariate distributions. We compare the doubly robust estimates with those obtained using three other methods: inverse probability weighting, regression adjustment, and propensity score matching. The results indicate that 20mph zones have had a significant causal impact on road casualty reduction in both absolute and proportional terms.

  6. Physiologic Waveform Analysis for Early Detection of Hemorrhage during Transport and Higher Echelon Medical Care of Combat Casualties

    Science.gov (United States)

    2014-03-01

    sequence analysis of finger blood pressure variability. Comparison with analysis of intra- arterial recordings. Hyper- tension 22: 26–33, 1993. 30. O’Rourke...detection of hemorrhage is crucial for managing combat casualties. However, mean arterial blood pressure (ABP) and other vital signs are late indicators of...physiologic mechanisms, mean arterial blood pressure (ABP) and other vital signs often change late and precipitously during progressive bleeding. By

  7. Assessment of Casualty Transport Equipment and Procedures Aboard U.S. Navy Submarines to Accommodate Anti-Shock Trousers

    Science.gov (United States)

    2012-10-24

    maternal morbidity and mortality 11-17. Two case series reports from Pakistan in the early 2000s noted remarkable improvement in women with severe...the effect of the NIASG upon mortality and severe morbidity in maternal hemorrhage and hypovolemic shock (NCT: 00488462). Data collection for this...stretcher-bound casualty up to the sail deck. If, however, such a route is necessary due to sea state or other complication, protective padding for

  8. Management of Junctional Hemorrhage in Tactical Combat Casualty Care: TCCC Guidelines-Proposed Change 13-03

    Science.gov (United States)

    2013-01-01

    reasons. The casu- alty had bilateral traumatic amputations of his lower extremities. He was reported to be unresponsive with no carotid pulse at...proximal iliac ves- sels remotely to secure hemostasis in case of high leg amputation .”16 The application time of the CRoC should not exceed 4...Winter 2013 devices on casualties in the prehospital environment. The available evidence as discussed in this report are laboratory studies and case

  9. INCIDENCE OF AMPUTATION IN EMERGENCY

    Directory of Open Access Journals (Sweden)

    K. Rojaramani Kumbha

    2016-08-01

    Full Text Available Advanced Technology and early detection of disease by recent improvements in investigation modalities lead to decreased incidents of amputations while Road Traffic Accidents (RTA increase. Furthermore, it leads to variation and decreased morbidity, mortality and accidents (crush injuries, and better equipped and trained staff, specialist services, diabetic food, rehabilitation centres, and giving good support physically and psychologically for Amputated patients. OBJECTIVE To know incidence rates of Emergency Amputation who attended causality with advanced disease and severe Trauma. METHODOLOGY The study is done over a period of one year i.e. between June 2015 to June 2016 who attended causality with advanced and severe disease affecting the limbs either due to diabetes, trauma or vascular diseases. RESULTS During one-year period, total 6,371 patients attended for general surgery OP. In those, 187 patients needed emergency surgery which included both major and minor operations. Among those, 81 patients were amputated. CONCLUSION As per our available records and observation, even though there is increased literacy and access to advanced technology, there is still increased incidence of patients undergoing amputations due to diseases. Therefore, there is a need to improve awareness and importance of early detection of diabetes, hazards of smoking, and regular general health checkups for patients at root level. With that we can treat diabetes and/or any disease in time. So there must be awareness in peripheral health staff i.e. PHC, subcentres, and community health centres about early detection of disease which in turn improves the quality of life of the patient. Due to diabetes slight injury to the glucose laden tissue may cause chronic infection and ulcer formation.(1 The tumours are seen commonly in the age group of 20-40 years after bone fusion, bones affected commonly are those around the knee (lower end of knee, upper end of tibia. A lytic

  10. Medication incidents reported to an online incident reporting system.

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

    AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

  11. Congestion with incidents

    DEFF Research Database (Denmark)

    Fosgerau, Mogens

    2010-01-01

    This paper considers the impact of random delays during a repeatedly occurring demand peak in a congested facility, such as an airport or an urban road. Congestion is described in the form of a dynamic queue using the Vickrey bottleneck model and assuming Nash equilibrium in departure times. Every...... period an incident may occur at a random time, temporarily reducing the bottleneck capacity to zero. The paper gives some properties of Nash equilibrium and the social optimum as well as a pretty good welfare improving tolling scheme....

  12. Medical examination of A-bomb survivors on Nagasaki A-bomb Casualty

    Energy Technology Data Exchange (ETDEWEB)

    Tagawa, Masuko [Nagasaki Atomic Bomb Casualty Council (Japan)

    1996-03-01

    Medical examination of A-bomb survivors was described and discussed on history, time change of examinee number, action for subjects not examined, change of prevalence, cancer examination, examination for the second generation, and education and enlightenment. Free examination of the survivors was begun in 1953 and the present casualty was made in 1958 on the law for medical care for the survivors. Systematic examination started from 1967 and the examination for the 2nd generation, from 1974. Cancer examination was from 1988. The number of the survivors was the maximum of 82,439 in 1974 and decreased to 61,388 in 1994, when the actual number of examinees, which being rather settled recently, was 32,294 and their average age was 64 y. The examination is done by tour or at the Center. Subjects receive the information of the examination twice by mail. Hematopoietic diseases like anemia, hepatic ones, metabolic and endocrinic ones like diabetes, renal impairment and others (mostly hyperlipidemia) are increasing recently. The number of examinees for cancer is increasing. Lung cancer is examined by the direct roentgenography, gastric cancer by transillumination, and other cancers like myeloma, those in large bowel, uterus and mammary gland, by the respective suitable methods. Health education and enlightenment have been conceivably effective. (H.O.)

  13. Assessment of the Casualty Risk of Multiple Meteorological Hazards in China

    Directory of Open Access Journals (Sweden)

    Wei Xu

    2016-02-01

    Full Text Available A study of the frequency, intensity, and risk of extreme climatic events or natural hazards is important for assessing the impacts of climate change. Many models have been developed to assess the risk of multiple hazards, however, most of the existing approaches can only model the relative levels of risk. This paper reports the development of a method for the quantitative assessment of the risk of multiple hazards based on information diffusion. This method was used to assess the risks of loss of human lives from 11 types of meteorological hazards in China at the prefectural and provincial levels. Risk curves of multiple hazards were obtained for each province and the risks of 10-year, 20-year, 50-year, and 100-year return periods were mapped. The results show that the provinces (municipalities, autonomous regions in southeastern China are at higher risk of multiple meteorological hazards as a result of their geographical location and topography. The results of this study can be used as references for the management of meteorological disasters in China. The model can be used to quantitatively calculate the risks of casualty, direct economic losses, building collapse, and agricultural losses for any hazards at different spatial scales.

  14. Epidemiology and Antimicrobial Susceptibilities of Wound Isolates of Obligate Anaerobes from Combat Casualties

    Science.gov (United States)

    White, Brian K.; Mende, Katrin; Weintrob, Amy C.; Beckius, Miriam L.; Zera, Wendy C.; Lu, Dan; Bradley, William; Tribble, David R.; Schnaubelt, Elizabeth R.; Murray, Clinton K.

    2015-01-01

    Data from recent conflicts related to war wounds and obligate anaerobes are limited. We define the epidemiology and antimicrobial susceptibility of obligate anaerobes from Iraq and Afghanistan casualties (6/2009–12/2013), as well as their association with clinical outcomes. Susceptibility against eleven antibiotics (7 classes) was tested. Overall, 59 patients had 119 obligate anaerobes identified (83 were first isolates). Obligate anaerobes were isolated 7–13 days post-injury, primarily from lower extremity wounds (43%), and were largely Bacteroides spp. (42%) and Clostridium spp. (19%). Patients with pelvic wounds were more likely to have Bacteroides spp. and concomitant resistant gram-negative aerobes. Seventy-three percent of isolates were resistant to ≥1 antimicrobials. Bacteroides spp. demonstrated the most resistance (16% of first isolates). Patients with resistant isolates had similar outcomes to those with susceptible strains. Serial recovery of isolates occurred in 15% of patients and was significantly associated with isolation of Bacteroides spp., along with resistant gram-negative aerobes. PMID:26607420

  15. Factor analysis of fatal road traffic crashes with massive casualties in China

    Directory of Open Access Journals (Sweden)

    Tao Chen

    2016-04-01

    Full Text Available Factor analysis refers to a collection of statistical methods for reducing correlational data into a smaller number of dimensions or factors. In this study, factor analysis theory was used to determine the main influential factors of road traffic crashes with massive casualties. Twenty variables related to personnel, vehicles, roads, and environment were collected, and the significance of their correlations was tested for validity. A correlation coefficient matrix R was calculated, and its latent root λ was obtained based on the characteristic equation. A number of common factors were determined according to the value of latent root λ . Factor loading was used to express the relationship of each variable to the underlying main influential factors. An index system of accident factors was developed based on the results of factor loading, and the weight of each factor was calculated to classify the factor influence. The main influential factors of accidents were determined to be fault behavior, driving experience, condition of vehicle safety, purpose of vehicle, road lighting, driver, road surface condition, roadside protection facilities, and road terrain.

  16. Premature chromosome condensation (PCC) assay for dose assessment in mass casualty accidents.

    Science.gov (United States)

    Lindholm, Carita; Stricklin, Daniela; Jaworska, Alicja; Koivistoinen, Armi; Paile, Wendla; Arvidsson, Eva; Deperas-Standylo, Joanna; Wojcik, Andrzej

    2010-01-01

    The study was undertaken to establish a dose calibration curve for a practical PCC ring assay and to apply it in a simulated mass casualty accident. The PCC assay was validated against the conventional dicentric assay. A linear relationship was established for PCC rings after (60)Co gamma irradiation with doses up to 20 Gy. In the simulated accident experiment, 62 blood samples were analyzed with both the PCC ring assay and the conventional dicentric assay, applying a triage approach. Samples received various uniform and non-uniform (10-40% partial-body) irradiations up to doses of 13 Gy. The results indicated that both assays yielded good dose estimates for the whole-body exposure scenario, although in the lower-dose range (0-6 Gy) dicentric scoring resulted in more accurate whole-body estimates, whereas PCC rings were better in the high-dose range (>6 Gy). Neither assay was successful in identifying partial-body exposures, most likely due to the low numbers of cells scored in the triage mode. In conclusion, the study confirmed that the PCC ring assay is suitable for use as a biodosimeter after whole-body exposure to high doses of radiation. However, there are limitations for its use in the triage of people exposed to high, partial-body doses.

  17. Global Earthquake Casualties due to Secondary Effects: A Quantitative Analysis for Improving PAGER Losses

    Science.gov (United States)

    Wald, David J.

    2010-01-01

    This study presents a quantitative and geospatial description of global losses due to earthquake-induced secondary effects, including landslide, liquefaction, tsunami, and fire for events during the past 40 years. These processes are of great importance to the US Geological Survey’s (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, which is currently being developed to deliver rapid earthquake impact and loss assessments following large/significant global earthquakes. An important question is how dominant are losses due to secondary effects (and under what conditions, and in which regions)? Thus, which of these effects should receive higher priority research efforts in order to enhance PAGER’s overall assessment of earthquakes losses and alerting for the likelihood of secondary impacts? We find that while 21.5% of fatal earthquakes have deaths due to secondary (non-shaking) causes, only rarely are secondary effects the main cause of fatalities. The recent 2004 Great Sumatra–Andaman Islands earthquake is a notable exception, with extraordinary losses due to tsunami. The potential for secondary hazards varies greatly, and systematically, due to regional geologic and geomorphic conditions. Based on our findings, we have built country-specific disclaimers for PAGER that address potential for each hazard (Earle et al., Proceedings of the 14th World Conference of the Earthquake Engineering, Beijing, China, 2008). We will now focus on ways to model casualties from secondary effects based on their relative importance as well as their general predictability.

  18. Performance and reliability of the CPB/ECMO Initiative Forward Lines Casualty Management System.

    Science.gov (United States)

    Casas, Fernando; Reeves, Andrew; Dudzinski, David; Weber, Stephan; Lorenz, Markus; Akiyama, Masatoshi; Kamohara, Keiji; Kopcak, Michael; Ootaki, Yoshio; Zahr, Firas; Sinkewich, Martin; Foster, Robert; Fukamachi, Kiyotaka; Smith, William A

    2005-01-01

    The Cleveland Clinic Foundation CPB/ECMO Initiative Forward Casualty Management System is an economical, compact, transportable, disposable system designed to permit a rapid expansion of trauma management services requiring cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) pulmonary support. The system, composed of a rotary blood pump, a pump motor driver, and an electronic control console as the blood pumping subsystem, also includes commonly used compatible commercial oxygenators, venous reservoirs, and cannulae. In vitro durability testing accumulated over 100 hours without failure. In vivo reliability was tested in 10 calves under general anesthesia during 6 hours of CPB and ECMO under full heparinization at nominal operating conditions of 4-5 l/min and 2-4 l/min blood flow respectively, and mean arterial pressures between 65 and 100 mm Hg. A mean time to failure of 57 hours was reached during the animal series. Results of these test series demonstrated that this system has the capability to reliably operate during a 6-hour conventional CPB or ECMO procedure, while providing flexibility and ease of use for the operator.

  19. Global earthquake casualties due to secondary effects: A quantitative analysis for improving rapid loss analyses

    Science.gov (United States)

    Marano, K.D.; Wald, D.J.; Allen, T.I.

    2010-01-01

    This study presents a quantitative and geospatial description of global losses due to earthquake-induced secondary effects, including landslide, liquefaction, tsunami, and fire for events during the past 40 years. These processes are of great importance to the US Geological Survey's (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, which is currently being developed to deliver rapid earthquake impact and loss assessments following large/significant global earthquakes. An important question is how dominant are losses due to secondary effects (and under what conditions, and in which regions)? Thus, which of these effects should receive higher priority research efforts in order to enhance PAGER's overall assessment of earthquakes losses and alerting for the likelihood of secondary impacts? We find that while 21.5% of fatal earthquakes have deaths due to secondary (non-shaking) causes, only rarely are secondary effects the main cause of fatalities. The recent 2004 Great Sumatra-Andaman Islands earthquake is a notable exception, with extraordinary losses due to tsunami. The potential for secondary hazards varies greatly, and systematically, due to regional geologic and geomorphic conditions. Based on our findings, we have built country-specific disclaimers for PAGER that address potential for each hazard (Earle et al., Proceedings of the 14th World Conference of the Earthquake Engineering, Beijing, China, 2008). We will now focus on ways to model casualties from secondary effects based on their relative importance as well as their general predictability. ?? Springer Science+Business Media B.V. 2009.

  20. The Internet's effect on personality traits: An important casualty of the "Internet addiction" paradigm.

    Science.gov (United States)

    Aboujaoude, Elias

    2017-03-01

    Background and aims The "Internet addiction" paradigm has been criticized for several shortcomings, including inattention to specific online behaviors, not distinguishing the Internet from other media, insufficient focus on comorbidities, and definitions that do not take into account the constant access now possible. The paradigm's biggest casualty, however, may be that it has diverted attention away from subtle personality changes that seem to occur online, including in users who cannot be considered "addicted" under any definition. Methods A narrative assessment of the literature was conducted, focusing on the Internet's effects on personality traits as revealed in studies of Internet users. Results Impulsivity, narcissism, and aggression are some of the personality traits that seem to be nurtured by the Internet, with possible negative offline consequences. Discussion Ignoring the Internet's subtle effects on personality as we embrace an addiction model that implies severe pathology makes the majority of Internet users feel deceptively immune to the psychological effects of new technologies. It also limits our understanding of the big cultural shifts that are happening as a result. Conclusion The Internet's potentially negative effect on personality, and by extension on society at large, is a fundamental part of online psychology, one well worthy of further investigation.

  1. Interlaboratory comparison of the dicentric chromosome assay for radiation biodosimetry in mass casualty events.

    Science.gov (United States)

    Wilkins, Ruth C; Romm, Horst; Kao, Tzu-Cheg; Awa, Akio A; Yoshida, Mitsuaki A; Livingston, Gordon K; Jenkins, Mark S; Oestreicher, Ursula; Pellmar, Terry C; Prasanna, Pataje G S

    2008-05-01

    This interlaboratory comparison validates the dicentric chromosome assay for assessing radiation dose in mass casualty accidents and identifies the advantages and limitations of an international biodosimetry network. The assay's validity and accuracy were determined among five laboratories following the International Organization for Standardization guidelines. Blood samples irradiated at the Armed Forces Radiobiology Research Institute were shipped to all laboratories, which constructed individual radiation calibration curves and assessed the dose to dose-blinded samples. Each laboratory constructed a dose-effect calibration curve for the yield of dicentrics for (60)Co gamma rays in the 0 to 5-Gy range, using the maximum likelihood linear-quadratic model, Y = c + alphaD + betaD(2). For all laboratories, the estimated coefficients of the fitted curves were within the 99.7% confidence intervals (CIs), but the observed dicentric yields differed. When each laboratory assessed radiation doses to four dose-blinded blood samples by comparing the observed dicentric yield with the laboratory's own calibration curve, the estimates were accurate in all laboratories at all doses. For all laboratories, actual doses were within the 99.75% CI for the assessed dose. Across the dose range, the error in the estimated doses, compared to the physical doses, ranged from 15% underestimation to 15% overestimation.

  2. The incidence of landmine injuries in Kuito, Angola.

    Science.gov (United States)

    Chaloner, E J

    1996-12-01

    Angola is one of the most heavily mined countries in the world. Despite the vast effort made to clear landmines, very few accurate figures for casualty rates are available. The town of Kuito in central Angola is surrounded by minefields left after the 22-month siege by the rebel UNITA forces. Many are in close proximity to residential areas. This retrospective audit assesses the incidence of landmine injuries in the wake of the siege, and the levels of amputation resulting from these wounds. Between January and October 1995, 94 landmine injuries occurred (60 from anti-personnel mines, 34 from anti-tank mines). Mine injuries accounted for 11.8% of the admissions to the surgical ward of Kuito hospital, but for 20.2% of the total number of operations performed. The distribution of injuries between the sexes was roughly equal (33 males: 27 females), but women required more above-knee amputations than men (16/20 versus 14/27). Mortality from anti-personnel mines was 1.7% (1/60). Seventy per cent of all lower limb amputations in Kuito are performed as a result of landmine injury (53/76). Landmines exert a severe strain on already stretched surgical services, and a significant burden of morbidity on the population of Kuito.

  3. Two incidents that changed quality management in the Australian livestock export industry

    Directory of Open Access Journals (Sweden)

    Peter R. Stinson

    2008-03-01

    Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

  4. Two incidents that changed quality management in the Australian livestock export industry.

    Science.gov (United States)

    Stinson, Peter R

    2008-01-01

    Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

  5. Grazing incidence beam expander

    Energy Technology Data Exchange (ETDEWEB)

    Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

    1985-01-01

    A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

  6. Transfusion service disaster planning.

    Science.gov (United States)

    Bundy, K L; Foss, M L; Stubbs, J R

    2008-01-01

    The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.

  7. Estimating the incidence of the acute coronary syndrome

    DEFF Research Database (Denmark)

    Nielsen, Kirsten M.; Foldspang, Anders; Larsen, Mogens L.

    2007-01-01

    of identification and control of the cohort under observation, (iii) inconsistencies in the use of diagnostic criteria, and (iv) missing data. We aimed to measure directly the incidence of the entire spectrum of the acute coronary syndrome (ACS), consisting of unstable angina pectoris, MI and sudden cardiac death......BACKGROUND: Estimates of incidence are crucial to the planning of public health measures, but most studies of incidence of, for example, acute myocardial infarction (MI) are troubled by methodological problems such as; (i) selection biases of the patients being included for study, (ii) lack...

  8. Sample tracking in an automated cytogenetic biodosimetry laboratory for radiation mass casualties

    Energy Technology Data Exchange (ETDEWEB)

    Martin, P.R.; Berdychevski, R.E.; Subramanian, U.; Blakely, W.F. [Armed Forces Radiobiology Research Institute, Uniformed Services University of Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States); Prasanna, P.G.S. [Armed Forces Radiobiology Research Institute, Uniformed Services University of Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States)], E-mail: prasanna@afrri.usuhs.mil

    2007-07-15

    Chromosome-aberration-based dicentric assay is expected to be used after mass-casualty life-threatening radiation exposures to assess radiation dose to individuals. This will require processing of a large number of samples for individual dose assessment and clinical triage to aid treatment decisions. We have established an automated, high-throughput, cytogenetic biodosimetry laboratory to process a large number of samples for conducting the dicentric assay using peripheral blood from exposed individuals according to internationally accepted laboratory protocols (i.e., within days following radiation exposures). The components of an automated cytogenetic biodosimetry laboratory include blood collection kits for sample shipment, a cell viability analyzer, a robotic liquid handler, an automated metaphase harvester, a metaphase spreader, high-throughput slide stainer and coverslipper, a high-throughput metaphase finder, multiple satellite chromosome-aberration analysis systems, and a computerized sample-tracking system. Laboratory automation using commercially available, off-the-shelf technologies, customized technology integration, and implementation of a laboratory information management system (LIMS) for cytogenetic analysis will significantly increase throughput. This paper focuses on our efforts to eliminate data-transcription errors, increase efficiency, and maintain samples' positive chain-of-custody by sample tracking during sample processing and data analysis. This sample-tracking system represents a 'beta' version, which can be modeled elsewhere in a cytogenetic biodosimetry laboratory, and includes a customized LIMS with a central server, personal computer workstations, barcode printers, fixed station and wireless hand-held devices to scan barcodes at various critical steps, and data transmission over a private intra-laboratory computer network. Our studies will improve diagnostic biodosimetry response, aid confirmation of clinical triage, and

  9. Organization and implementation of medical rescue of mass casualties during earthquake

    Directory of Open Access Journals (Sweden)

    Yan-ling ZHANG

    2012-01-01

    Full Text Available Over the past century, there were more than 40 earthquakes greater than 7 magnitude occurred worldwide, 10 of which in China, which killed 600 thousand people accounting for 53% of global earthquake deaths. On May 12, 2008, an 8.0-magnitude earthquake occurred in Wenchuan, Sichuan Province, causing 69000 deaths, 18000 missings, and 370000 injuries. Among 10 thousand severe injuries, most were traumatic injuries, 74% of which were fracture. On April 14, 2010, a 7.1-magnitude earthquake occurred in Yushu, Qinghai Province. There were 2698 deaths, 270 missings and 11000 injuries. Among 3100 severe injuries, fracture accounted for 58.4%. After each earthquake, the Chinese Army Medical Services took actions and made quick response according to the law. They sent out elites with efficient command and scientific organization, fully participating in the medical rescue operations. After Wenchuan earthquake, 397 mobile medical service units and 7061 health workers were sent out. A total of 69000 people were treated, and 22000 cases of surgeries were performed. After Yushu earthquake, a total of 25 mobile medical service units and 2025 health workers were sent. They performed 1635 cases of surgeries with a miracle of "zero death" in mass earthquake casualties and altitude diseases in cold highlands. After each earthquake, injuries cured within 1 week accounted for 60% of the total, and patients evacuated accounted for 80% of the total, which owed to the effective first aid in site of Chinese Army Medical Service. They effectively played the role as the main force, making significant contributions for the final victory of earthquake relief. From the practice of medical rescue revelation after the two earthquakes, what Chinese Army Medical Services Services learned are: firstly, the theory of medical relief should be innovated; secondly, military and civilian organizations should be coordinated; thirdly, professional rescue force should be strengthened

  10. Preparedness for the Evaluation and Management of Mass Casualty Incidents Involving Anticholinesterase Compounds: A Survey of Emergency Department Directors in the 12 Largest Cities in the United States

    Science.gov (United States)

    2010-11-01

    Division, US Army dical Research Institute of Chemical Defense (USAMRICD), Me A berdeen Proving Ground, Maryland. Mic haell. Greenberg , MD, MPH...seizure activity in the guinea pig . Arch Toxicol. 2003; 77(3): 167-172. 88. Capacio BR. Byers CE, Merk KA, et a1. : Pharmacokinetic studies of...intramuscular midazolam in guinea pigs challenged with soman. Drug Chem 1bxicol. 2004; 27(2): 95-110. 89. GHat E, Kadar T, Levy A, et al.: Anticonvulsant

  11. Recovery from chemical, biological, and radiological incidents :

    Energy Technology Data Exchange (ETDEWEB)

    Franco, David Oliver; Yang, Lynn I.; Hammer, Ann E.

    2012-06-01

    To restore regional lifeline services and economic activity as quickly as possible after a chemical, biological or radiological incident, emergency planners and managers will need to prioritize critical infrastructure across many sectors for restoration. In parallel, state and local governments will need to identify and implement measures to promote reoccupation and economy recovery in the region. This document provides guidance on predisaster planning for two of the National Disaster Recovery Framework Recovery Support Functions: Infrastructure Systems and Economic Recovery. It identifies key considerations for infrastructure restoration, outlines a process for prioritizing critical infrastructure for restoration, and identifies critical considerations for promoting regional economic recovery following a widearea disaster. Its goal is to equip members of the emergency preparedness community to systematically prioritize critical infrastructure for restoration, and to develop effective economic recovery plans in preparation for a widearea CBR disaster.

  12. Incidence of emergency contacts (red responses to Norwegian emergency primary healthcare services in 2007 – a prospective observational study

    Directory of Open Access Journals (Sweden)

    Hansen Elisabeth

    2009-07-01

    Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics

  13. Physiologic Waveform Analysis for Early Detection of Hemorrhage during Transport and Higher Echelon Medical Care of Combat Casualties

    Science.gov (United States)

    2012-11-01

    compensatory reserve index for predicting which casualties are in imminent danger of cardiovascular collapse and (b) application of the techniques to the...second dog; norepi- nephrine and xylazine in the third dog; saline and progressive hem- orrhage in the fourth dog; verapamil and high-rate pacing in the...0 113 1 Norepinephrine 134 15 162 22 55 11 117 13 Xylazine 65 8 78 8 25 1 100 10 Saline 98 1 119 1 45 1 137 1 Hemorrhage 66 5 80 5 25 1 105 4

  14. 成批烧伤救治50年%Experiences in rescue and treatment of mass burn casualties in fifty years

    Institute of Scientific and Technical Information of China (English)

    周一平

    2008-01-01

    The article reviewed the history and the main experiences of rescue of mass burn casualties and their treatment during the past fifty years in China. Some issues including medical support for mass burn casually and treatment regime in future, such as the prevention of burn calamities, further elevation of the eure rate and lowering in the rate of disability, further development in network of burn care and preliminary scheme of rescue of mass burn casualties and their treatment, accelerating the development and study on the substitutes of allo-skin graft were discussed.

  15. Blind Persons Report Critical Incidents of Science and Mathematics Instruction.

    Science.gov (United States)

    Sica, Morris G.

    This project identified over 500 critical incidents of successful and unsuccessful instruction in science and mathematics courses reported through interviews of 105 blind college students. The principal categories of effective teacher behavior included planned concrete learning experiences, creative use of learning materials, and detailed…

  16. Formal analysis of empirical traces in incident management

    NARCIS (Netherlands)

    Hoogendoorn, M.; Jonker, C.M.; Maanen, P.P. van; Sharpanskykh, A.

    2008-01-01

    Within the field of incident management split second decisions have to be made, usually on the basis of incomplete and partially incorrect information. As a result of these conditions, errors occur in such decision processes. In order to avoid repetition of such errors, historic cases, disaster plan

  17. Econometric analysis of the changing effects in wind strength and significant wave height on the probability of casualty in shipping.

    Science.gov (United States)

    Knapp, Sabine; Kumar, Shashi; Sakurada, Yuri; Shen, Jiajun

    2011-05-01

    This study uses econometric models to measure the effect of significant wave height and wind strength on the probability of casualty and tests whether these effects changed. While both effects are in particular relevant for stability and strength calculations of vessels, it is also helpful for the development of ship construction standards in general to counteract increased risk resulting from changing oceanographic conditions. The authors analyzed a unique dataset of 3.2 million observations from 20,729 individual vessels in the North Atlantic and Arctic regions gathered during the period 1979-2007. The results show that although there is a seasonal pattern in the probability of casualty especially during the winter months, the effect of wind strength and significant wave height do not follow the same seasonal pattern. Additionally, over time, significant wave height shows an increasing effect in January, March, May and October while wind strength shows a decreasing effect, especially in January, March and May. The models can be used to simulate relationships and help understand the relationships. This is of particular interest to naval architects and ship designers as well as multilateral agencies such as the International Maritime Organization (IMO) that establish global standards in ship design and construction.

  18. Choosing a coverage probability for forecasting the incidence of cancer.

    Science.gov (United States)

    Young, Derek S; Mills, Terence M

    2014-10-15

    Loddon Mallee Integrated Cancer Service plays a key role in planning the delivery of cancer services in the Loddon Mallee Region of Victoria, Australia. Such planning relies on the accuracy of forecasting the incidence of cancer. Perhaps more importantly is the need to reflect the uncertainty of these forecasts, which is usually carried out through prediction intervals. Standard confidence levels (e.g., 90% or 95%) are typically employed when forecasting the incidence of cancer, but decision-theoretic approaches are available to help choose an optimal coverage probability by minimizing the combined risk of the interval width and noncoverage of the interval. We proceed with the decision-theoretic framework and discuss some general strategies for defining candidate loss functions for forecasting the incidence of cancer, such as the data we analyze for the Loddon Mallee Region.

  19. Learning from incidents and accidents

    NARCIS (Netherlands)

    Drupsteen, L.; Kampen, J. van

    2014-01-01

    There are many different definitions for what constitutes an incident or an accident, however the focus is always on unintended and often unforeseen events that cause unintended consequences. This article is focused on the process of learning from incidents and accidents. The focus is on making sure

  20. Harnessing Critical Incidents for Learning

    Science.gov (United States)

    Patahuddin, Sitti Maesuri; Lowrie, Tom

    2015-01-01

    A critical incident is a situation or event that holds significance for learning, both for the students and teachers. This paper presents four examples of critical incidents from a Year 7 teacher's lesson excerpts in Indonesia involving teaching of fractions, to show how they shaped classroom situation, brought forward elements of conflict, and…

  1. Spatial planning

    OpenAIRE

    Dimitrov, Nikola; Koteski, Cane

    2016-01-01

    The professional book ,, Space planning "processed chapters on: space, concept and definition of space, space as a system, spatial economics, economic essence of space, space planning, social determinants of spatial planning, spatial planning as a process, factors development and elements in spatial planning, methodology, components and content of spatial planning stages and types of preparation of spatial planning, spatial planning and industrialization, industrialization, urbanization and s...

  2. Longitudinal Characterization of Acinetobacter baumannii-calcoaceticus Complex, Klebsiella pneumoniae, and Methicillin-Resistant Staphylococcus aureus Colonizing and Infecting Combat Casualties

    Science.gov (United States)

    2012-01-01

    Brief report Longitudinal characterization of Acinetobacter baumannii-calcoaceticus complex, Klebsiella pneumoniae , and methicillin-resistant...resistant Acinetobacter baumannii-calcoaceticus complex Klebsiella pneumoniae Methicillin-resistant Staphylococcus aureus MRSA Drug-resistant...Acinetobacter baumannii-calcoaceticus complex, Klebsiella pneumoniae , and methicillin- resistant Staphylococcus aureus colonize and infect combat casualties

  3. Decreasing incidence rates of bacteremia

    DEFF Research Database (Denmark)

    Nielsen, Stig Lønberg; Pedersen, C; Jensen, T G;

    2014-01-01

    BACKGROUND: Numerous studies have shown that the incidence rate of bacteremia has been increasing over time. However, few studies have distinguished between community-acquired, healthcare-associated and nosocomial bacteremia. METHODS: We conducted a population-based study among adults with first......-acquired, 50.0 for healthcare-associated and 66.7 for nosocomial bacteremia. During 2000-2008, the overall incidence rate decreased by 23.3% from 254.1 to 198.8 (3.3% annually, p ...) and the incidence rate of nosocomial bacteremia decreased by 28.9% from 82.2 to 56.0 (4.2% annually, p

  4. Police Incident Blotter (30 Day)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The 30 Day Police Blotter contains the most recent initial crime incident data, updated on a nightly basis. All data is reported at the block/intersection level,...

  5. Idiot Savants: Rate of Incidence

    Science.gov (United States)

    Hill, A. Lewis

    1977-01-01

    A survey of 300 public residential facilities for the mentally retarded revealed a .06 percent incidence rate for idiot savants, persons of low intelligence who possess an unusually high skill in some special task. (CL)

  6. Cyber Incidents Involving Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Robert J. Turk

    2005-10-01

    The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Management Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this

  7. Cancer estimation of incidence and survival in Algeria 2014

    Directory of Open Access Journals (Sweden)

    Hamdi Cherif M

    2015-10-01

    Full Text Available Cancer is one of the major public health problems in Algeria. In the last 25 years, a significant increase in the incidence of the major types of cancers has been observed in both sexes. Moreover, the 5-year survival rate is low for the severe tumors due to a difficulty in access to cancer care and an incomplete health care framework. Cancer Registry of Setif, Algeria, has been recording cancer incidence, mortality, and survival since 1986 in collaboration with International Agency for Research on Cancer (IARC of Lyon. Cancer Registry of Setif is being a source of information for cancer planning and corresponding surveillance in the National Cancer Plan 2015-2019, starting in January 2015. Data is recorded by means of CanReg 5 software. This software is developed and provided by the International Agency for Research on Cancer (IARC of Lyon. It is designed specifically for cancer registration, and standardized to capture, control, and process the data. Estimation of cancer incidence in Algeria and survival rates are very important for surveillance, control, and planning of care. In men the incidence of lung, colorectal, bladder, prostate, and laryngeal cancers has significantly and steadily increased in the last decade. In women, the incidence of breast, colorectal, thyroid, and lung cancers has also increased significantly in the same period. Five-year survival rates for cancer of the stomach, colon, rectum, liver, lung, breast, cervix, ovary, and prostate in adults, and childhood leukemia are relatively low compared with other countries. The aim of our study was to estimate incidence and survival by means of Setif cancer registry data.

  8. 基于最低人员伤亡的资源优化配置模型研究%Study of optimized allocation model for emergency resource based on minimal casualties

    Institute of Scientific and Technical Information of China (English)

    赵洪海; 李明泽; 李忠伟

    2011-01-01

    The present paper is aiming at introducing an optimized allocation model for emergency resource based on the minimal casualties in case of incidence of an unexpected disaster involving the entire city sphere. In order to optimize the emergency resource allocation based on the existing available emergency resources to be allocated, first of all, we have made careful consideration of the means for such kind of allocation. The so-called emergency resources can be divided into human resources, material resources and message resources according to their ability to perform their own respective functions. The urban emergency-available shelter, for instance, is a special temporary place that can provide secure refuge and basic facilities for people to shelter themselves in during the recovery period after a natural disaster. Also, it is an important means for the international society to deal with the emergent events and victims for mutual benefits. In order to minimize the total economic loss and minimize the number of casualty, it is desirable to allocate the available resources in an optimized manner. However, the traditional or habitual manner to manage the emergency resources in our country is based on the local authorities' experience without any clear-minded guide or theory for appropriate quantitative or qualitative allocation criteria and often leads to the failure to achieve the best advantage of the resources as is expected. And, secondly, the most influential factor for optimizing resource allocation in disaster-hitting period is time-urgency. The reason for this is obvious because the response to the disaster sufferers must be prompt, instantaneous and immediate, or unconditional. Therefore, we have given a detailed discussion over the most influential parameters that are likely relevant here. What is more, we have brought about a fatality model open to an open discussion. In our model, we have illustrated all the fatalities involving the likely

  9. Planning Lessons

    Institute of Scientific and Technical Information of China (English)

    Linda Jensen

    2007-01-01

    @@ Jensen's "Lesson Planning"article serves aS a guide fOr novice teachers who need to create formalized lesson plans.The article covers why,when,and how teachers plan lessons,as well aS basic lesson plan principles and a lesson plan template.

  10. Book review of "The Ethics of Coercion in Mass Casualty Medicine" by Griffin Trotter MD, PhD

    Directory of Open Access Journals (Sweden)

    Singh Sonal

    2007-10-01

    Full Text Available Abstract Public health ethics is neither taught widely in medical schools or schools of public health in the US or around the world. It is not surprising that health care professionals are particularly challenged when faced with ethical questions which extend beyond safeguarding the interests of their individual patients to matters that affect overall public good. The perceived threat of terror after September 11 2007, the anthrax attacks and the Katrina debacle are recent circumstances which may result in coercion. These have piqued the interest of medical professionals and the general public on public health ethics. The Ethics of Coercion in Mass Casualty Medicine written by Griffin Trotter MD, PhD attempts to fill a timely void in this area by examining the ethics of coercion in times of public health disasters.

  11. Addenda to Allied Medical Publication 8, NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN) Casualties (AMedP-8(C)) to Consider the Impact of Medical Treatment on Casualty Estimation

    Science.gov (United States)

    2013-05-01

    114 F. Venezuelan Equine Encephalitis (VEE) Model Parameters (Section C128) ..117 1. Deletions...staphylococcal enterotoxin B (SEB), Venezuelan Equine Encephalitis (VEE), plague, and smallpox. In addition, although sometimes considered a chemical agent...pre-symptom onset antibiotic prophylaxis) is assumed to be efficacious for a percentage of the population, independent of dose; there is no defeat

  12. NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN) Casualties (AMedP-8(C)) - Parameters for Estimation of Casualties from Exposure to Specified Biological Agents. Addenda to Allied Medical Publication 8

    Science.gov (United States)

    2011-01-01

    estimating the numbers of persons developing illness or dying from anthrax, botulism, Venezuelan equine encephalitis, plague, and smallpox. Five additional...the non-contagious biological agent explanation in Section 0106.7b, following the Venezuelan equine encephalitis (VEE) assumptions and limitations...comprehensive clinical studies of tularemia available were reported in the pre- antibiotic era before inhalation was understood to be a potential route of

  13. Language Planning: Corpus Planning.

    Science.gov (United States)

    Baldauf, Richard B., Jr.

    1989-01-01

    Focuses on the historical and sociolinguistic studies that illuminate corpus planning processes. These processes are broken down and discussed under two categories: those related to the establishment of norms, referred to as codification, and those related to the extension of the linguistic functions of language, referred to as elaboration. (60…

  14. Reported fatal and non-fatal incidents involving tourists in Thailand, July 1997-June 1999.

    Science.gov (United States)

    Leggat, Peter A; Leggat, Frances W

    2003-05-01

    Objectives. To examine fatal and non-fatal incidents involving tourists in Thailand. Methods. Press records from a major English language newspaper for the period from July 1997 to June 1999 were examined for reports of fatal and non-fatal incidents involving tourists. Results. From July 1997 to June 1999, up to 233 deaths were reported and up to a further 216 were reported injured in incidents involving tourists. One hundred and one deaths and 45 injured were reported following one major domestic jet aircraft crash in southern Thailand, however, it was not stated what proportion of casualties were tourists. Approximately 90 people perished in a single hotel fire in southeast Thailand. Most of the victims were local travellers attending meetings of two Thai companies. Sixteen deaths and 86 injured resulted from five road accidents. The majority of deaths and injuries involved foreigners. Twelve deaths and at least 33 injured resulted from three ferry and tour boat accidents. Most victims were reported to be foreigners. Three deaths and 35 injured resulted from a single cable car accident in northern Thailand. Most of these were Thai tourists, however, four of the injured were foreigners. Eight deaths and six injured resulted from 11 muggings and other violent incidents. All were foreigners. Six deaths were reportedly connected to a scam at the airport in Bangkok involving unlicensed airport taxis. Three deaths and four injured were due to other reported incidents. Conclusions. Newspaper reports of fatal and non-fatal incidents involving tourists in Thailand were probably uncommon, particularly given the volume of tourists entering the Kingdom, although better reporting mechanisms are needed. With the exception of the unusual major incidents, most reported fatal and non-fatal incidents involving tourists were due to road trauma and other transportation accidents, muggings, and occasional water sports and other accidents, which could occur at any major tourist

  15. [Stationary thromboprophylaxis in casualty surgery. Relevance of postoperative mobility and preexisting risk factors].

    Science.gov (United States)

    Eisele, R; Maier, E; Kinzl, L; Gude, U

    2004-04-01

    The presented thromboprophylactic concept includes weight bearing and ankle motion as well as breathing therapy and drug prophylaxis (antiphlogistics, analgesic drugs, heparin). Routinely performed ultrasound screening of the deep veins (legs and pelvis) before release showed a low DVT incidence of 2.5% in a prospective clinical observation of 841 inpatients. Obesity, venous insufficiency, and a history of previous thromboembolic events were associated with a significantly increased risk of thrombosis (relative risk 4.1, 4,9, and 5.8, respectively) The duration of immobilization also had a relevant influence indicating that early postoperative physiotherapy in traumatology and orthopedic surgery has a widely underestimated thromboprophylactic effect.

  16. Planned inguinal herniorrhaphy but no hernia sac?

    DEFF Research Database (Denmark)

    Jensen, P; Bay-Nielsen, M; Kehlet, H

    2004-01-01

    Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention.......Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention....

  17. Cardiovascular disease incidence and survival

    DEFF Research Database (Denmark)

    Byberg, Stine; Agyemang, Charles; Zwisler, Ann Dorthe

    2016-01-01

    Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute...... significantly lower incidence of CVD, AMI and stroke. All-cause and cause-specific survival after CVD, AMI and stroke was similar or significantly better for migrants compared to Danish-born, regardless of type of migrant (refugee vs. family-reunified) or country of origin. Refugees are disadvantaged in terms...... of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health....

  18. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  19. Lay emphasis on the treatment of massive burn casualties in conflagration%重视火灾事故成批烧伤的救治

    Institute of Scientific and Technical Information of China (English)

    唐洪泰; 马兵; 夏照帆

    2012-01-01

    Burn surgery helongs to disaster medicine.Burn is a common trauma that occurs in social activities of human beings in all ages,either in the time of peace or war.During the development of human medicine in modern times,the summary of experience in treating massive burn casualties due to severe fire accidents has effectively promoted the renovation of treating technology and theory of burns and the development of burn surgery.The results of treatment of burn injury in casualties occurred in the fire of Cocoanut Grove night club in Boston in 1942,and the high-rise apartment house fire in Shanghai in 2010 were summarized and analyzed in this article,emphasizing the correlating issues of inhalation injury.

  20. Casualty Assistance: DOD and the Coast Guard Need to Develop Policies and Outreach Goals and Metrics for Program Supporting Servicemembers Survivors

    Science.gov (United States)

    2016-06-01

    Government Accountability Office United States Government Accountability Office Highlights of GAO-16-569, a report to the Committee on Armed...assistance process following the death of a servicemember. Senate Report 114-49 included a provision that GAO review the Gold Star Advocate...following the death of a servicemember.2 Casualty assistance is the provision of authorized and necessary assistance to eligible family members of

  1. Use and Complications of Operative Control of Arterial Inflow in Combat Casualties with Traumatic Lower-extremity Amputations Caused by Improvised Explosive Devices

    Science.gov (United States)

    2013-08-01

    injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee . J Surg Orthop Adv. 2012;21:32Y37. 11. Andersen RC...methods of proximal control in high wartime lower-extremity amputees . Although some casualties will have abdominal injuries that necessitate...of suprainguinal vascular control and complications that arose. In cases where multiple levels of control were used, data on all vessels were collected

  2. Development of Balloon Multifunctional Vest for Casualty Triage%气囊式多功能伤员分类服的研制

    Institute of Scientific and Technical Information of China (English)

    孙海安; 刘晓荣; 刘宏鸣; 陈国良; 刘飞; 唐和蔚

    2012-01-01

    Objective To realize quick triage of massive casualties on the sea for the enhancement of naval medical support. Methods Proper materials and independent balloon were used to make the vest with the PLA's uniform size referenced. Results The balloon multifunctional vest could be used for the quick triage of massive casualties on the sea. Conclusion The balloon multifunctional vest for casualty triage can guarantee the timely treatment on the sea, and the naval medical support ability can be enhanced accordingly%目的:实现海上批量伤员快速分类,完成海上急救任务,提升海上卫勤保障能力.方法:参照解放军军服尺寸,选用适当材料,结合独立气囊制成背心.结果:气囊式多功能伤员分类服可以满足海上卫勤保障中批量伤员迅速分类的需求.结论:气囊式多功能伤员分类服保证了海上伤员救治的时效性,对提高海上卫勤保障能力有重要作用.

  3. Reducing young driver crash casualties in Great Britain - use of routine police crash data to estimate the potential benefits of graduated driver licensing.

    Science.gov (United States)

    Jones, Sarah J; Begg, Dorothy J; Palmer, Stephen R

    2013-01-01

    Crashes involving young drivers (YD) cause significant morbidity and mortality in Great Britain (GB). Graduated Driver Licensing (GDL) is used in some countries to address this. This study assessed potential casualty and cost savings of possible GDL programmes in GB. Police road crash data were analysed to identify YD crashes at night or while carrying passengers. These data were then used to estimate the potential effects of GDL. 314,561 casualties and 3469 fatalities occurred in YD crashes. 25.1% of YD crashes occurred between 9 pm and 6 am and 24.4% occurred with a 15- to 24-year old passenger in the car. A 'strict' form of GDL in GB (night time restriction 9 pm-6 am, no 15-24 year old passengers) with 50% compliance would prevent 114 deaths and 872 serious casualties each year. The estimated value of prevention is £424M pa. A 'less strict' form of GDL (night time restriction 10 pm-5 am, maximum of one 15-19 year old passenger) with 50% compliance would prevent 81 deaths and 538 serious injuries. The estimated value of prevention is £273M pa. Implementing GDL in GB could save significant numbers of lives. Public health organisations have a duty to advocate for such legislation.

  4. EDs credit drills, community engagement with helping them manage casualties from tornado crises.

    Science.gov (United States)

    2011-07-01

    Emergency department leaders at DCH Regional Medical Center in Tuscaloosa, AL, and Cullman Regional Medical Center in Cullman, AL, credit their regular practice drills with helping them deal with unprecedented demand when deadly tornadoes swept through the South this past April. Both facilities used the hospital instant command structure (HICS) to mobilize the resources needed to care for the surge in patients, and say the approach worked well in helping them meet the needs of their communities. However, the crises also showcased opportunities for improvement. The ED at DCH Regional Medical Center saw more than 600 patients on the day of the storm, a three-fold increase in the hospital's typical volume. CRMC treated 99 patients in the seven hours immediately following the storm when it usually treats 114 patients per day. In addition to a big surge in patients, both hospitals dealt with power outages that limited access to some services such as radiology. Triage proved particularly challenging at DCH Regional Medical Center, as patients flowed into the hospital from numerous access points. The hospital plans to assign coordinators to each area of the hospital to better manage the influx in the future. When reviewing emergency operations plans, Joint Commission reviewers often find deficiencies in hazard vulnerability analyses as well as the processes used to determine the emergency credentials of licensed independent practitioners.

  5. Good Gradings of Generalized Incidence Rings

    CERN Document Server

    Price, Kenneth L

    2011-01-01

    This inquiry is based on both the construction of generalized incidence rings due to Gene Abrams and the construction of good group gradings of incidence algebras due to Molli Jones. We provide conditions for a generalized incidence ring to be graded isomorphic to a subring of an incidence ring over a preorder. We also extend Jones's construction to good group gradings for incidence algebras over preorders with crosscuts of length one or two.

  6. Crippling Violence: Conflict and Incident Polio in Afghanistan.

    Directory of Open Access Journals (Sweden)

    Alison Norris

    Full Text Available Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question.We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009.We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404.The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.

  7. Critical incident. An ethical dilemma.

    Science.gov (United States)

    County, B

    2000-10-01

    The purpose of this critical incident analysis is to demonstrate how knowledge of legal, moral and ethical issues has affected my nursing practice. This is a personal journey--an exploration of my own values and beliefs. The piece demonstrates how reviewing the literature has changed my stance on the issues discussed. Consequently, the piece is written in the first person, but references are used to substantiate my findings.

  8. Investigating the association between weather conditions, calendar events and socio-economic patterns with trends in fire incidence: an Australian case study

    Science.gov (United States)

    Corcoran, Jonathan; Higgs, Gary; Rohde, David; Chhetri, Prem

    2011-06-01

    Fires in urban areas can cause significant economic, physical and psychological damage. Despite this, there has been a comparative lack of research into the spatial and temporal analysis of fire incidence in urban contexts. In this paper, we redress this gap through an exploration of the association of fire incidence to weather, calendar events and socio-economic characteristics in South-East Queensland, Australia using innovative technique termed the quad plot. Analysing trends in five fire incident types, including malicious false alarms (hoax calls), residential buildings, secondary (outdoor), vehicle and suspicious fires, results suggest that risk associated with all is greatly increased during school holidays and during long weekends. For all fire types the lowest risk of incidence was found to occur between one and six a.m. It was also found that there was a higher fire incidence in socially disadvantaged neighbourhoods and there was some evidence to suggest that there may be a compounding impact of high temperatures in such areas. We suggest that these findings may be used to guide the operations of fire services through spatial and temporal targeting to better utilise finite resources, help mitigate risk and reduce casualties.

  9. Cancer incidence in pulmonary vasculitis.

    Science.gov (United States)

    Zycinska, Katarzyna; Kostrzewa-Janicka, Jolanta; Nitsch-Osuch, Aneta; Wardyn, Kazimierz

    2013-01-01

    Pulmonary vasculitis is a potentially lethal autoimmune disease characterized by granulomatous inflammation of respiratory tract, necrotizing vasculitis affecting small-to medium-size vessels and antineutrophil cytoplasmic antibodies elevation. Typical therapy involves high-dose glucocorticosteroids combined with cyclophosphamide in a dose 1-2 mg/kg/per day. A high relapse rate in pulmonary vasculitis means prolonged courses of cyclophosphamide in some patients. Carcinogenic effects of cyclophosphamide, especially its toxic metabolite acrolein that is excreted into the urine, are responsible for the development of acute myeloid leukemia (AML) and bladder cancer. These and other malignancies are cyclophosphamide dose-depended. The aim of the present study was to assess the incidence of cancer in patients with pulmonary vasculitis in comparison with the incidence of cancer in the general population. Analyses were done according to the cumulative dose of cyclophosphamide, subdivided into low (≤35 g) and high (>35 g). During the observation period 15 cancers occurred. A significantly increased standardized incidence ratio (SIR) was observed for non-melanoma skin cancers (SIR 5.2; 95 % Cl 2.3-8.7), AML (SIR 4.3; 95 % Cl 2.1-11.2), and bladder cancer (SIR 3.4; 95 % Cl 1.6-5.2). Induction remission treatment and relapse treatment with cyclophosphamide involves a substantial risk of late appearing malignances in patients with pulmonary vasculitis. Monitoring and prophylactic management in pulmonary vasculitis after cessation of cyclophosphamide therapy is crucial.

  10. Homeland security: sharing and managing critical incident information

    Science.gov (United States)

    Ashley, W. R., III

    2003-09-01

    Effective critical incident response for homeland security requires access to real-time information from many organizations. Command and control, as well as basic situational awareness, are all dependant on quickly communicating a dynamically changing picture to a variety of decision makers. For the most part, critical information management is not unfamiliar or new to the public safety community. However, new challenges present themselves when that information needs to be seamlessly shared across multiple organizations at the local, state and federal level in real-time. The homeland security problem does not lend itself to the traditional military joint forces planning model where activities shift from a deliberate planning process to a crisis action planning process. Rather, the homeland security problem is more similar to a traditional public safety model where the current activity state moves from complete inactivity or low-level attention to immediate crisis action planning. More often than not the escalation occurs with no warning or baseline information. This paper addresses the challenges of sharing critical incident information and the impacts new technologies will have on this problem. The value of current and proposed approaches will be critiqued for operational value and areas will be identified for further development.

  11. Evaluation of a Scalable Information Analytics System for Enhanced Situational Awareness in Mass Casualty Events

    Directory of Open Access Journals (Sweden)

    Aura Ganz

    2016-01-01

    Full Text Available We investigate the utility of DIORAMA-II system which provides enhanced situational awareness within a disaster scene by using real-time visual analytics tools and a collaboration platform between the incident commander and the emergency responders. Our trials were conducted in different geographical areas (feature-rich and featureless regions and in different lighting conditions (daytime and nighttime. DIORAMA-II obtained considerable time gain in efficiency compared to conventional paper based systems. DIORAMA-II time gain was reflected in reduction of both average triage time per patient (up to 34.3% average triage time reduction per patient and average transport time per patient (up to 76.3% average transport time reduction per red patient and up to 66.3% average transport time reduction per yellow patient. In addition, DIORAMA-II ensured that no patients were left behind or transported in the incorrect order compared to the conventional method which resulted in patients being left behind and transported in the incorrect order.

  12. Micronucleus test for radiation biodosimetry in mass casualty events: Evaluation of visual and automated scoring

    Energy Technology Data Exchange (ETDEWEB)

    Bolognesi, Claudia, E-mail: claudia.bolognesi@istge.i [Environmental Carcinogenesis Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Balia, Cristina; Roggieri, Paola [Environmental Carcinogenesis Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Cardinale, Francesco [Clinical Epidemiology Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Department of Health Sciences, University of Genoa, Genoa (Italy); Bruzzi, Paolo [Clinical Epidemiology Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Sorcinelli, Francesca [Environmental Carcinogenesis Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Laboratory of Genetics, Histology and Molecular Biology Section, Army Medical and Veterinary, Research Center, Via Santo Stefano Rotondo 4, 00184 Roma (Italy); Lista, Florigio [Laboratory of Genetics, Histology and Molecular Biology Section, Army Medical and Veterinary, Research Center, Via Santo Stefano Rotondo 4, 00184 Roma (Italy); D' Amelio, Raffaele [Sapienza, Universita di Roma II Facolta di Medicina e Chirurgia and Ministero della Difesa, Direzione Generale Sanita Militare (Italy); Righi, Enzo [Frascati National Laboratories, National Institute of Nuclear Physics, Via Enrico Fermi 40, 00044 Frascati, Rome (Italy)

    2011-02-15

    In the case of a large-scale nuclear or radiological incidents a reliable estimate of dose is an essential tool for providing timely assessment of radiation exposure and for making life-saving medical decisions. Cytogenetics is considered as the 'gold standard' for biodosimetry. The dicentric analysis (DA) represents the most specific cytogenetic bioassay. The micronucleus test (MN) applied in interphase in peripheral lymphocytes is an alternative and simpler approach. A dose-effect calibration curve for the MN frequency in peripheral lymphocytes from 27 adult donors was established after in vitro irradiation at a dose range 0.15-8 Gy of {sup 137}Cs gamma rays (dose rate 6 Gy min{sup -1}). Dose prediction by visual scoring in a dose-blinded study (0.15-4.0 Gy) revealed a high level of accuracy (R = 0.89). The scoring of MN is time consuming and requires adequate skills and expertise. Automated image analysis is a feasible approach allowing to reduce the time and to increase the accuracy of the dose estimation decreasing the variability due to subjective evaluation. A good correlation (R = 0.705) between visual and automated scoring with visual correction was observed over the dose range 0-2 Gy. Almost perfect discrimination power for exposure to 1-2 Gy, and a satisfactory power for 0.6 Gy were detected. This threshold level can be considered sufficient for identification of sub lethally exposed individuals by automated CBMN assay.

  13. [Effects of Ward Interventions on Repeated Critical Incidents in Child and Adolescent Psychiatric Inpatient Care].

    Science.gov (United States)

    Ulke, Christine; Klein, Annette M; von Klitzing, Kai

    2014-01-01

    Effects of Ward Interventions on Repeated Critical Incidents in Child and Adolescent Psychiatric Inpatient Care. The aim of this study was to evaluate the effects of several ward interventions (transition to an open ward concept, individualized treatment plans, tiered crisis-management, staff training, quality control) on repeated critical incidents, non-restrictive and restrictive measures. The outcome variables were compared in two time periods, 2007 and 2011. The study included 74 critical incident reports of 51 child and adolescent inpatients that had at least one hospital stay and one critical incident in the selected time periods. Aggressive, self-harming, and absconding incidents were included. The quantitative results suggest that ward interventions can contribute to a reduction of repeated critical incidents and restrictive measures. The qualitative evaluation suggests a cultural change of crisis management.

  14. A Review of Socio-Economic Consequences, Losses and Human Casualties of the 1977 Vrancea, Romania Earthquake

    Directory of Open Access Journals (Sweden)

    Emil-Sever GEORGESCU

    2011-01-01

    Full Text Available Although its socio-economic disaster pattern was obvious, the March 4, 1977 Vrancea, Romania earthquake was studied mainly in seismological and earthquake engineering terms. In 1977, the loss data released in Romania, referred to 32,900 collapsed or heavily damaged dwellings, 35,000 homeless families, thousands of damaged buildings, many other damages and destructions in industry and economy, 1,578 people killed, 11,321 people injured (with 90% of the killed and 67% of the injured being in the city of Bucharest. The Romanian government reported the economic losses from this event in December 1977, as being US$ 2 billion. For a long time, the evaluation of human casualties vs. collapse pattern of buildings in 1977 was not addressed and we still miss integral data. The recovery and reevaluation of economic and social impacts of the 1977 disaster was a concern of the authors, with the intent to better understand its consequences and prepare a new strategy of seismic risk reduction in view of future earthquakes in Romania, and in order to fill that gap the authors recovered many unpublished and obscure data.

  15. Patterns of Road Traffic Accidents in North West of Iran during 2013 New Year Holidays: Complications and Casualties

    Directory of Open Access Journals (Sweden)

    Samad Shams Vahdati

    2014-04-01

    Full Text Available Objective: To determine the patterns,complications and casualties of road traffic accidents in North West of Iran during 2013 New Year holidays. Methods: One hundred and eighty one patients with trauma-related vehicle crashes were investigated in a cross sectional-descriptive study. We only included those road traffic accidents which were recorded during the 2013 Iranian New Year holidays. Severity of injury based on Glasgow Coma Scale (GCS score, patient transmission type, damaged organ and the final diagnosis was determined. The mortality rate as well as complications were also recorded and reported. The pattern was analyzed and presented using descriptive statistics. Results: Overall we included 181 patients who were victims of road traffic accidents during the study period. Most cases of multiple traumas were from two car accident (49.2%. Of 181 cases, 71 (39.2%, 66 (36.5%, 16 (8.8% and 11 (6.1% subjects had limb, head and neck, abdominal, and spinal cord injuries respectively, while 16 cases (8.8% did not have any organ damage. In final diagnosis, a limb fracture was noticed in 32 cases (17.7% and skull fractures in 5 subjects (2.8% as the first and second causes. Conclusion: As head and neck were the most damaged organs after the limbs in patients with multiple traumas, it seems that there is a necessity for these patients in transmission and examination of head traumas. So there is a need for a proper referral system.

  16. Mass Casualties and Health Care Following the Release of Toxic Chemicals or Radioactive Material—Contribution of Modern Biotechnology

    Science.gov (United States)

    Göransson Nyberg, Ann; Stricklin, Daniela; Sellström, Åke

    2011-01-01

    Catastrophic chemical or radiological events can cause thousands of casualties. Such disasters require triage procedures to identify the development of health consequences requiring medical intervention. Our objective is to analyze recent advancements in biotechnology for triage in mass emergency situations. In addition to identifying persons “at risk” of developing health problems, these technologies can aid in securing the unaffected or “worried well”. We also highlight the need for public/private partnerships to engage in some of the underpinning sciences, such as patho-physiological mechanisms of chemical and radiological hazards, and for the necessary investment in the development of rapid assessment tools through identification of biochemical, molecular, and genetic biomarkers to predict health effects. For chemical agents, biomarkers of neurotoxicity, lung damage, and clinical and epidemiological databases are needed to assess acute and chronic effects of exposures. For radiological exposures, development of rapid, sensitive biomarkers using advanced biotechnologies are needed to sort exposed persons at risk of life-threatening effects from persons with long-term risk or no risk. The final implementation of rapid and portable diagnostics tools suitable for emergency care providers to guide triage and medical countermeasures use will need public support, since commercial incentives are lacking. PMID:22408587

  17. Investigating risk factors of traffic casualties at private highway-railroad grade crossings in the United States.

    Science.gov (United States)

    Haleem, Kirolos

    2016-10-01

    Private highway-railroad grade crossings (HRGCs) are intersections of highways and railroads on roadways that are not maintained by a public authority. Since no public authority maintains private HRGCs, fatal and injury crashes at these locations are of concern. However, no study has been conducted at private HRGCs to identify the safety issues that might exist and how to alleviate them. This study identifies the significant predictors of traffic casualties (including both injuries and fatalities) at private HRGCs in the U.S. using six years of nationwide crashes from 2009 to 2014. Two levels of injury severity were considered, injury (including fatalities and injuries) and no injury. The study investigates multiple predictors, e.g., temporal crash characteristics, geometry, railroad, traffic, vehicle, and environment. The study applies both the mixed logit and binary logit models. The mixed logit model was found to outperform the binary logit model. The mixed logit model revealed that drivers who did not stop, railroad equipment that struck highway users, higher train speeds, non-presence of advance warning signs, concrete road surface type, and cloudy weather were associated with an increase in injuries and fatalities. For example, a one-mile-per-hour higher train speed increases the probability of fatality by 22%. On the contrary, male drivers, PM peak periods, and presence of warning devices at both approaches were associated with a fatality reduction. Potential strategies are recommended to alleviate injuries and fatalities at private HRGCs.

  18. Safety Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Swan Lake National Wildlife Refuge Safety Plan discusses policies for the safety of the station employees, volunteers, and public. This plan seeks to identify...

  19. Planning Diseases.

    Science.gov (United States)

    Gabel, Medard

    1984-01-01

    To solve societal problems, both local and global, a global approach is needed. Serious diseases that are crippling present-day problem solving and planning are discussed, and the characteristics of a healthy, effective planning approach are described. (RM)

  20. Fire Plans

    Science.gov (United States)

    Power, June

    2011-01-01

    Many libraries have disaster recovery plans, but not all have prevention and action plans to prepare for an emergency in advance. This article presents the author's review of the prevention and action plans of several libraries: (1) Evergreen State College; (2) Interlochen Public Library; (3) University of Maryland, Baltimore-Marshall Law Library;…

  1. Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study

    DEFF Research Database (Denmark)

    Patterson, Christopher C; Dahlquist, Gisela G; Gyürüs, Eva

    2009-01-01

    BACKGROUND: The incidence of type 1 diabetes in children younger than 15 years is increasing. Prediction of future incidence of this disease will enable adequate fund allocation for delivery of care to be planned. We aimed to establish 15-year incidence trends for childhood type 1 diabetes in Eur...

  2. Generation of Vertically Incident Seismograms,

    Science.gov (United States)

    1985-09-01

    p. 106, equation 3.38.) %lPHASE Flag: If set, Minimum- phase filter required; otherwise, Zero phase %ILNR Counter of model file input lines, used in... PHASE ) FILTER -TYPE DB SLOPE CUT-OFF FREQUENCY 1 72 70 2 72 30 4’ 4 GENERATION OF VERTICALLY INCIDENT SEISMOGRAMS VISP; PLOTS OF PARAMETERS TEST I...FILTER PHASE 1 (MINIMUM PHASE ) FILTER -TYPE DB SLOPE CUT-OFF FREQUENCY 1 96 50 2 96 10 Table 6. Input data used to test a high-cult filter with zero phase

  3. Grazing incidence diffraction : A review

    Energy Technology Data Exchange (ETDEWEB)

    Gilles, B. [LTPCM, ENSEEG. St. Martin d`Heres. (France)

    1996-09-01

    Different Grazing Incidence Diffraction (GID) methods for the analysis of thin films and multilayer structures are reviewed in three sections: the reflectivity is developed in the first one, which includes the non-specular diffuse scattering. The second one is devoted to the extremely asymmetric Bragg diffraction and the third one to the in-plane Bragg diffraction. Analytical formulations of the scattered intensities are developed for each geometry, in the framework of the kinetical analysis as well as the dynamical theory. Experimental examples are given to illustrate the quantitative possibility of the GID techniques.

  4. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller;

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  5. Ionospheric Oblique Incidence Soundings by Satellites

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The oblique incidence sweep-frequency ionospheric sounding technique uses the same principle of operation as the vertical incidence sounder. The primary difference...

  6. USFA NFIRS 2013 Fire Incident & Cause Data

    Data.gov (United States)

    Department of Homeland Security — The 2013 Fire Causes & Incident data was provided by the U.S. Fire Administration’s (USFA) National Fire Data Center’s (NFDC’s) National Fire Incident Reporting...

  7. Liver cancer incidence and mortality in China, 2009

    Institute of Scientific and Technical Information of China (English)

    Wan-Qing Chen; Rong-Shou Zheng; Si-Wei Zhang

    2013-01-01

    Liver cancer is a common cancer and a leading cause of cancer deaths in China.To aid the government in establishing a control plan for this disease,we provided real-time surveillance information by analyzing liver cancer incidence and mortality in China in 2009 reported by the National Central Cancer Registry.Liver cancer incidence and cases of death were retrieved from the national database using the ICD-10 topography code "C22".Crude incidence and mortality were calculated and stratified by sex,age,and location (urban/rural).China's population in 1982 and Segi (world) population structures were used for age-standardized rates.In cancer registration areas in 2009,the crude incidence of liver cancer was 28.71/100,000,making it the fourth most common cancer in China,third most common in males,and fifth most common in females.The crude mortality of liver cancer was 26.04/100,000,making it the second leading cause of cancer death in China and urban areas and the third leading cause in rural areas.Incidence and mortality were higher in males than in females and were higher in rural areas than in urban areas.The age-specific incidence and mortality were relatively low among age groups under 30years but dramatically increased and peaked in the 80-84 years old group.These findings confirm that liver cancer is a common and fatal cancer in China.Primary and secondary prevention such as health education,hepatitis B virus vaccination,and early detection should be carried out both in males and females,in urban and rural areas.

  8. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  9. LAND USE PLANNING AND URBAN PLANS: TERRITORIAL BALANCE AS ETHICS

    Directory of Open Access Journals (Sweden)

    Eunice Helena Sguizzardi Abascal

    2012-07-01

    Full Text Available The article suggests a necessary link between urban planning and territorial organization, in order to, through the synergistic relationship between planning tools and their application to planning, implementing a policy of urban and regional management. By linking the development plan for territorial development plans and categories of land use, this methodology helps to streamline operations at multiple scales. The establishment of this network of instruments and shapes the actions of government action against the rapid and intense increase of only economic forces that shape the territory today, suggesting that it is possible to regulate the action of the housing market through planned interventions, valuing the regional balance, social and environmental - ethical by definition. It is suggested that the possible effects predatory natural and built environment can be reversed or prevented by an action articulating these planning instruments are linked to the development and implementation of plans (and projects at multiple scales, approaching from the regional to the local and metropolitan, from regional policies to sectors, that are incidents in the municipal territory. However, the speed and magnitude of the occupation and transformation of soil occur mainly in periods of heating housing, often jeopardize the balance and environmental quality, natural heritage, urban and landscape. It assumes the argument that the overcoming of undesirable environmental effects, triggered by occupation of the ground guided by the real estate sector fast action can be successful with the articulation of levels of planning and intervention. It is proposed that the complexity of contemporary urban and metropolitan requires the articulation of different scales through the use of innovative urban instruments. By articulating these different scales, at the municipal and other levels supra, contributes to, through a network plan to overcome the undesirable dichotomy

  10. Detecting Terrorism Incidence Type from News Summary

    DEFF Research Database (Denmark)

    Nizamani, Sarwat; Memon, Nasrullah

    2012-01-01

    The paper presents the experiments to detect terrorism incidence type from news summary data. We have applied classification techniques on news summary data to analyze the incidence and detect the type of incidence. A number of experiments are conducted using various classification algorithms and...

  11. TB incidence in an adolescent cohort in South Africa.

    Directory of Open Access Journals (Sweden)

    Hassan Mahomed

    Full Text Available BACKGROUND: Tuberculosis (TB is a major public health problem globally. Little is known about TB incidence in adolescents who are a proposed target group for new TB vaccines. We conducted a study to determine the TB incidence rates and risk factors for TB disease in a cohort of school-going adolescents in a high TB burden area in South Africa. METHODS: We recruited adolescents aged 12 to 18 years from high schools in Worcester, South Africa. Demographic and clinical information was collected, a tuberculin skin test (TST performed and blood drawn for a QuantiFERON TB Gold assay at baseline. Screening for TB cases occurred at follow up visits and by surveillance of registers at public sector TB clinics over a period of up to 3.8 years after enrolment. RESULTS: A total of 6,363 adolescents were enrolled (58% of the school population targeted. During follow up, 67 cases of bacteriologically confirmed TB were detected giving an overall incidence rate of 0.45 per 100 person years (95% confidence interval 0.29-0.72. Black or mixed race, maternal education of primary school or less or unknown, a positive baseline QuantiFERON assay and a positive baseline TST were significant predictors of TB disease on adjusted analysis. CONCLUSION: The adolescent TB incidence found in a high burden setting will help TB vaccine developers plan clinical trials in this population. Latent TB infection and low socio-economic status were predictors of TB disease.

  12. The causes and circumstances of drinking water incidents impact consumer behaviour: Comparison of a routine versus a natural disaster incident.

    Science.gov (United States)

    Rundblad, Gabriella; Knapton, Olivia; Hunter, Paul R

    2014-11-18

    When public health is endangered, the general public can only protect themselves if timely messages are received and understood. Previous research has shown that the cause of threats to public health can affect risk perception and behaviours. This study compares compliance to public health advice and consumer behaviour during two "Boil Water" notices issued in the UK due to a routine incident versus a natural disaster incident. A postal questionnaire was sent to 1000 randomly selected households issued a routine "Boil Water" notice. Findings were then compared to a previous study that explored drinking water behaviour during a "Boil Water" notice issued after serious floods. Consumers affected by the routine incident showed a significant preference for official water company information, whereas consumers affected by the natural disaster preferred local information sources. Confusion over which notice was in place was found for both incidents. Non-compliance was significantly higher for the natural disaster (48.3%) than the routine incident (35.4%). For the routine incident, compliance with advice on drinking as well as preparing/cooking food and brushing teeth was positively associated with receiving advice from the local radio, while the opposite was true for those receiving advice from the water company/leaflet through the post; we suggest this may largely be due to confusion over needing boiled tap water for brushing teeth. No associations were found for demographic factors. We conclude that information dissemination plans should be tailored to the circumstances under which the advice is issued. Water companies should seek to educate the general public about water notices and which actions are safe and unsafe during which notice, as well as construct and disseminate clearer advice on brushing teeth and preparing/cooking food.

  13. The Causes and Circumstances of Drinking Water Incidents Impact Consumer Behaviour: Comparison of a Routine versus a Natural Disaster Incident

    Directory of Open Access Journals (Sweden)

    Gabriella Rundblad

    2014-11-01

    Full Text Available When public health is endangered, the general public can only protect themselves if timely messages are received and understood. Previous research has shown that the cause of threats to public health can affect risk perception and behaviours. This study compares compliance to public health advice and consumer behaviour during two “Boil Water” notices issued in the UK due to a routine incident versus a natural disaster incident. A postal questionnaire was sent to 1000 randomly selected households issued a routine “Boil Water” notice. Findings were then compared to a previous study that explored drinking water behaviour during a “Boil Water” notice issued after serious floods. Consumers affected by the routine incident showed a significant preference for official water company information, whereas consumers affected by the natural disaster preferred local information sources. Confusion over which notice was in place was found for both incidents. Non-compliance was significantly higher for the natural disaster (48.3% than the routine incident (35.4%. For the routine incident, compliance with advice on drinking as well as preparing/cooking food and brushing teeth was positively associated with receiving advice from the local radio, while the opposite was true for those receiving advice from the water company/leaflet through the post; we suggest this may largely be due to confusion over needing boiled tap water for brushing teeth. No associations were found for demographic factors. We conclude that information dissemination plans should be tailored to the circumstances under which the advice is issued. Water companies should seek to educate the general public about water notices and which actions are safe and unsafe during which notice, as well as construct and disseminate clearer advice on brushing teeth and preparing/cooking food.

  14. Medical lessons learnt from the US and Canadian experience of treating combat casualties from Afghanistan and Iraq.

    Science.gov (United States)

    Dharm-Datta, Shreshth; McLenaghan, J

    2013-06-01

    The Winston Churchill Memorial Trust, established in 1965, funds Travelling Fellowships and both authors visited hospitals in Germany, Canada and the USA regarded as centres of excellence with expertise in the early care, reconstruction and rehabilitation of the combat casualties of our NATO Allies, as recipients of these Fellowships. This article presents some of the lessons learnt in the field of musculoskeletal trauma and rehabilitation from the Canadian and US military medical systems. In trauma, there were significant differences in wound debridement policy, use of external fixators for fractures, primary use of circular frames for open tibial fractures and a far more liberal use of bone morphogenetic protein in fracture treatment. Differences in soft tissue reconstruction policy regarding flaps for soft tissue cover over exposed bone, near-universal usage of topical negative pressure dressings and use of Allgöwer-Donati suture pattern to close all wounds were noted. Ertl amputation osteoplasty, a modified form of transtibial amputation, had also been reintroduced. In rehabilitation, the management of heterotopic ossification, in particular with imaging techniques and excision surgery, was identified. For the upper limb, we observed the patient training required to use a myoelectric hand and the future possibility of targeted muscle re-innervation to make controlling these myoelectric prostheses more natural using innate motor patterns. For the lower limb, we found we used identical above knee prostheses. For patients who have had limb reconstruction and have poor function, an energy-storing orthosis was demonstrated to compensate for the loss of range of motion and muscle power.

  15. An Engineer’s Mathematical Approach to Designing an Emergency Room Decontamination Area for Weapons of Mass Destruction Casualties

    Directory of Open Access Journals (Sweden)

    Eldo E. Frezza

    2007-01-01

    Full Text Available This study will focus on the potential requirements for an emergency response facility in case of weapons of mass destruction casualties proposing mathematical models. A complete emergency room layout will be designed taking the following analyses and requirements into consideration: quality function development (QFD and product layout; average number of patients in the system, average time in the system, average number of patients in the waiting queue and average time waiting in the queue. Our analysis showed that, assuming 150 patients per day for 2 days with average service time of 14 minutes with two lines running. λ = 75 arrivals/day = 0.0521 arrivals/min. µ = 2 patients/14min = 0.1429 patients/min. Average number of patients in system (waiting and being served. Ls = λ / (µ - λ = 0.574 patients. Average time in system (waiting and service time Ws = 1 / (µ - λ = 11.02 min. Average number of patients waiting in queue. Lq = λ2 / µ (µ - λ = 0.209 patients Average time waiting in queue, Wq = λ / µ (µ - λ = 4.016 min. From our model, we conclude to set up an engineer’s perfect ER response we need: Having a stable patient and unstable patient track will make it easy to respond to the emergency. Patients requiring the emergency track feature would be dropped off before the vehicle shower at contaminated stabilizing rooms. Time of service: waiting 14 minutes with an average of 2 patients waiting in line to be served. This is an initial study having a flow of 150 patients arriving over a long time period and it is an attempt to apply a mathematical model to a multidisciplinary approach to a clinical potential discussion.

  16. An introduction to incidence geometry

    CERN Document Server

    De Bruyn, Bart

    2016-01-01

    This book gives an introduction to the field of Incidence Geometry by discussing the basic families of point-line geometries and introducing some of the mathematical techniques that are essential for their study. The families of geometries covered in this book include among others the generalized polygons, near polygons, polar spaces, dual polar spaces and designs. Also the various relationships between these geometries are investigated. Ovals and ovoids of projective spaces are studied and some applications to particular geometries will be given. A separate chapter introduces the necessary mathematical tools and techniques from graph theory. This chapter itself can be regarded as a self-contained introduction to strongly regular and distance-regular graphs. This book is essentially self-contained, only assuming the knowledge of basic notions from (linear) algebra and projective and affine geometry. Almost all theorems are accompanied with proofs and a list of exercises with full solutions is given at the end...

  17. RADIATION CONTAMINATION INCIDENT AT ISOLDE

    CERN Multimedia

    2000-01-01

    On 27 June 2000 three specialists were investigating a problem with the extraction electrode of the high-resolution separator (HRS) in Isolde. Whilst using an endoscope in order to have a closer look at the interior, they came into contact with radioactive dust and became contaminated. The level of contamination was low and the radiation dose received by the 3 persons was far below the effective dose limit given in the CERN Radiation Safety Manual and in the regulations of the Host States.According to the usual procedure, the Director General has set up a Fact-Finding Group and an Accident Board in order to advise him on the steps and decisions tobe taken following this incident and in particular to avoid a recurrence.

  18. Investigation of KW reactor incident

    Energy Technology Data Exchange (ETDEWEB)

    Sturges, D G [USAEC Hanford Operations Office, Richland, WA (United States); Hauff, T W; Greager, O H [General Electric Co., Richland, WA (United States). Hanford Atomic Products Operation

    1955-02-11

    The new KW reactor was placed in operation on January 4, 1955, and had been running at relatively low power levels for only 17 hours when it was shut down because of a process tube water leak which appeared to be associated with a slug rupture. After several days of unrewarding effort to remove the slugs and tube by customary methods, it developed that considerable melting of the tube and slugs had taken place. It was then evident that removal of the stuck mass and repairs to the damaged tube channel would require unusual measures that were certain to extend the reactor outage for several weeks. This report documents the work and findings of the Committee which investigated the KW reactor incident. Its content represents unanimous agreement among the three Committee members.

  19. 成批重度烧伤患者相关感染的个体化治疗%Individualized treatment of infection on mass severe burn casualties

    Institute of Scientific and Technical Information of China (English)

    巴特

    2016-01-01

    Successful treatment of mass severe burn casualties is one of the important criteria to test the emergency response ability of department. Burn sepsis, pulmonary infection, local wound infection, enterogenous infection, and a series of infections in the process of mass burn casualties are seriously threatening the life of the patients. In addition to the routine treatment of patients with severe burn, this article focuses on the individual treatment programs for patients with different infections, and achieved good results. Mass burn casualties with severe burn treatment, need to adjust the specific circumstances, in order to maximize the success rate of treatment.%成批重度烧伤患者的成功救治是考验科室对突发事件应急能力的重要标准之一。成批烧伤患者救治的过程中,烧伤脓毒症、肺部感染、局部创面感染以及肠源性感染等一系列感染问题严重地威胁着患者的生命。除了对重度烧伤患者的常规治疗以外,本文着重介绍了针对患者不同感染情况进行的个体化治疗方案,并且取得良好效果。成批重度烧伤患者的治疗,需要针对具体情况进行调整,才能最大程度地提高救治成功率。

  20. Spatial analysis of highway incident durations in the context of Hurricane Sandy.

    Science.gov (United States)

    Xie, Kun; Ozbay, Kaan; Yang, Hong

    2015-01-01

    The objectives of this study are (1) to develop an incident duration model which can account for the spatial dependence of duration observations, and (2) to investigate the impacts of a hurricane on incident duration. Highway incident data from New York City and its surrounding regions before and after Hurricane Sandy was used for the study. Moran's I statistics confirmed that durations of the neighboring incidents were spatially correlated. Moreover, Lagrange Multiplier tests suggested that the spatial dependence should be captured in a spatial lag specification. A spatial error model, a spatial lag model and a standard model without consideration of spatial effects were developed. The spatial lag model is found to outperform the others by capturing the spatial dependence of incident durations via a spatially lagged dependent variable. It was further used to assess the effects of hurricane-related variables on incident duration. The results show that the incidents during and post the hurricane are expected to have 116.3% and 79.8% longer durations than those that occurred in the regular time. However, no significant increase in incident duration is observed in the evacuation period before Sandy's landfall. Results of temporal stability tests further confirm the existence of the significant changes in incident duration patterns during and post the hurricane. Those findings can provide insights to aid in the development of hurricane evacuation plans and emergency management strategies.

  1. The grave is wide: the Hibakusha of Hiroshima and Nagasaki and the legacy of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation.

    Science.gov (United States)

    O'Malley, Gerald F

    2016-07-01

    Following the atomic bomb attacks on Japan in 1945, scientists from the United States and Japan joined together to study the Hibakusha - the bomb affected people in what was advertised as a bipartisan and cooperative effort. In reality, despite the best efforts of some very dedicated and earnest scientists, the early years of the collaboration were characterized by political friction, censorship, controversy, tension, hostility, and racism. The 70-year history, scientific output and cultural impact of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation are described in the context of the development of Occupied Japan.

  2. [Conditions for the survival of combat casualties in overseas operations: procedure and experience from the Afghan out-of-hospital theater].

    Science.gov (United States)

    Palmier, Bruno

    2012-01-01

    Recent conflicts have led the French Army Health Service to specify the setting condition for the survival of combat casualties in overseas operations. The majority of them are victims of explosion injuries, and an early and effective control of bleeding is the primary means of improving survival. A procedure called "Combat Rescue" is taught. This chronological procedure favours external haemostasis and led to specific equipment, in particular a tourniquet and a haemostatic bandage of high efficiency. It is applied in recent years on the Afghan out-of-hospital theatre. A very front medical presence, which is systematic during evacuations, is a feature of the French Army Health Service operations support.

  3. Temporal-spatial Distribution Regularities of Forest Fire Casualties in China%我国森林火灾中人员伤亡时空分布特征研究

    Institute of Scientific and Technical Information of China (English)

    杨光; 舒立福; 孙思琦; 邸雪颖; 刘畅

    2015-01-01

    Based on forest fire statistics (2000-2012) and typical cases available in China, and by using statistical analysis method and ARCMAP spatial analysis method, the forest fire statistics with the same period of the countries where the forest fire frequently occurred in the world are compared, and the temporal-spatial distribu-tion regularities of forest fire casualties in China are analyzed.Results indicate that the forest fires caused heavy casualties during the period of 1988-2012 in China, the proportion of forest fire casualties was much higher than that of North America in that period.There were more forest fire casualties in seriously arid years.Spring was high-occurrence seasons for forest fire casualties, and the forest fire casualties of spring account for 54.2% of the total according to the statistics of 2000-2012.March was high-occurrence months for forest fire casualties, and the for-est fire casualties of March account for 33.7% of the total according to the statistics of 1999-2012.The central and southwestern areas were densely injured areas, the forest fire casualties of the southwestern areas account for 35.5%of the total and the forest fire casualties of the center areas account for 24.3%of the total during the period of 2000-2012.The Yunnan and Hunan were densely injured provinces, the forest fire casualties were found most in Yunnan and mainly involving in minor injury, and the number of minor injury casualties in Yunnan account for 73.0%of the total during the period of 2000-2012 .%基于我国1988-2012年森林火灾统计资料及典型案例,运用统计分析方法和ARCMAP空间分析方法,对比同时期世界上几个森林火灾多发国家的统计数据,分析了我国森林火灾中人员伤亡时空特征。结果表明:1988-2012年我国森林火灾造成的人员伤亡情况较为严重,森林火灾中人员伤亡比例远高于同时期的北美国家;森林火灾中人员伤亡高发于干旱严重的年份;春

  4. Steel Planning

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    China releases a new plan for the iron and steel industry centered on industrial upgrades The new 12th Five-Year Plan (2011-15) for China’s iron and steel industry, recently released on the website of the Ministry of Industry and Information

  5. Test plan :

    Energy Technology Data Exchange (ETDEWEB)

    Dwyer, Stephen F.

    2013-05-01

    This test plan is a document that provides a systematic approach to the planned testing of rooftop structures to determine their actual load carrying capacity. This document identifies typical tests to be performed, the responsible parties for testing, the general feature of the tests, the testing approach, test deliverables, testing schedule, monitoring requirements, and environmental and safety compliance.

  6. Systemic Planning

    DEFF Research Database (Denmark)

    Leleur, Steen

    This book presents principles and methodology for planning in a complex world. It sets out a so-called systemic approach to planning, among other things, by applying “hard” and “soft” methodologies and methods in combination. The book is written for Ph.D and graduate students in engineering......, business and other fields, and it is useful for all professionals, across a wide range of employment areas, who share an interest in renewing planning practice. Such an endeavour is seen as both important and timely, recognising that many complex planning tasks necessitate organisations – be they public...... or private – to engage in planning to prepare proactive decision-making....

  7. Fuzzy Logic for Incidence Geometry.

    Science.gov (United States)

    Tserkovny, Alex

    The paper presents a mathematical framework for approximate geometric reasoning with extended objects in the context of Geography, in which all entities and their relationships are described by human language. These entities could be labelled by commonly used names of landmarks, water areas, and so forth. Unlike single points that are given in Cartesian coordinates, these geographic entities are extended in space and often loosely defined, but people easily perform spatial reasoning with extended geographic objects "as if they were points." Unfortunately, up to date, geographic information systems (GIS) miss the capability of geometric reasoning with extended objects. The aim of the paper is to present a mathematical apparatus for approximate geometric reasoning with extended objects that is usable in GIS. In the paper we discuss the fuzzy logic (Aliev and Tserkovny, 2011) as a reasoning system for geometry of extended objects, as well as a basis for fuzzification of the axioms of incidence geometry. The same fuzzy logic was used for fuzzification of Euclid's first postulate. Fuzzy equivalence relation "extended lines sameness" is introduced. For its approximation we also utilize a fuzzy conditional inference, which is based on proposed fuzzy "degree of indiscernibility" and "discernibility measure" of extended points.

  8. Fuzzy Logic for Incidence Geometry

    Science.gov (United States)

    2016-01-01

    The paper presents a mathematical framework for approximate geometric reasoning with extended objects in the context of Geography, in which all entities and their relationships are described by human language. These entities could be labelled by commonly used names of landmarks, water areas, and so forth. Unlike single points that are given in Cartesian coordinates, these geographic entities are extended in space and often loosely defined, but people easily perform spatial reasoning with extended geographic objects “as if they were points.” Unfortunately, up to date, geographic information systems (GIS) miss the capability of geometric reasoning with extended objects. The aim of the paper is to present a mathematical apparatus for approximate geometric reasoning with extended objects that is usable in GIS. In the paper we discuss the fuzzy logic (Aliev and Tserkovny, 2011) as a reasoning system for geometry of extended objects, as well as a basis for fuzzification of the axioms of incidence geometry. The same fuzzy logic was used for fuzzification of Euclid's first postulate. Fuzzy equivalence relation “extended lines sameness” is introduced. For its approximation we also utilize a fuzzy conditional inference, which is based on proposed fuzzy “degree of indiscernibility” and “discernibility measure” of extended points. PMID:27689133

  9. Technical Reference Manual: NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN), Casualties, Allied Medical Publication-8(C)

    Science.gov (United States)

    2010-08-01

    chemical blister agent HD (distilled mustard); the biological agents causing anthrax, botulism, pneumonic plague, smallpox, and Venezuelan equine ...Countermeasures—Vaccination/ Antibiotic Prophylaxis ............181 7. Literature Review and Parameter Development .......................................181 8...203 4. Venezuelan Equine Encephalitis (VEE) ....................................................212 E

  10. Marketing plan

    OpenAIRE

    Jantunen, Essi; Hellman, Annika

    2012-01-01

    The aim of this bachelor’s thesis was to draw up an efficient marketing plan for Pohjolan Vihreä Polku Oy, which offers meeting and nature activity services. The company was in a process of conversion and needed a structured marketing plan. The objectives of the company were perceived through severe research. The main purposes of the marketing plan were to raise the visibility of the company and increase its clientele. The proposed marketing actions are also to be used to improve the company’...

  11. GRIPS Plan

    Energy Technology Data Exchange (ETDEWEB)

    1978-07-31

    The GRIPS (Geothermal Resources Impact Projection Study) Commission was established by a Joint Powers Agreement between the California Counties of Lake, Mendocino, Napa, and Sonoma. The objectives of GRIPS are primarily to develop and use a cooperative environmental data collection and use system including natural, social, and economic considerations to facilitate their independent decisions and those of State and Federal agencies related to the environmental effects of geothermal development. This GRIPS Plan was prepared from a wide range of studies, workshops, and staff analyses. The plan is presented in four parts: summary and introduction; environmental data status report; planned programs; and budget. (MHR)

  12. Hypothyroidism incidence in and around pregnancy

    DEFF Research Database (Denmark)

    Andersen, Stine Linding; Carle, Allan; Olsen, Jørn;

    2016-01-01

    -2010 (overall IR 92.3/100,000/year) and 1,572 women developed hypothyroidism in the period from 2 years before to 2 years after birth of the first child birth in the study period. The incidence of hypothyroidism decreased during the pregnancy (incidence rate ratio (IRR) versus overall IR in the rest...... of hypothyroidism in and around pregnancy. The incidence declined during pregnancy followed by a sharp increase postpartum. Notably, hypothyroidism as opposed to hyperthyroidism showed no early pregnancy peak....

  13. 谈亡人火灾事故调查工作的规范%On the Regulation of Fire Investigations Involving Fire Casualties

    Institute of Scientific and Technical Information of China (English)

    陈岩

    2012-01-01

    Fire accidents with casualties concern the interest of victims. The identification of fire causes is crucial in properly handling the fire accidents of this kind. This paper focuses on specific steps, investigation standards and requirements for reference to the fire investigation of the accidents with casualties.%亡人火灾涉及当事人的切身利益,规范做好亡人火灾的调查工作,准确认定火灾原因,是妥善处理亡人火灾事故的重要基础和前提,对维护社会和谐稳定具有十分重要的意义。结合实践经验,重点针对亡人火灾调查中一些容易忽视的环节,提出工作的标准和要求,以期对规范亡人火灾的调查工作提供实际指导。

  14. Analysis of Casualty Risk per Police-Reported Crash for Model Year 2000 to 2004 Vehicles, using Crash Data from Five States

    Energy Technology Data Exchange (ETDEWEB)

    Wenzel, Tom

    2011-03-20

    In this report we compare two measures of driver risks: fatality risk per vehicle registration-year, and casualty (fatality plus serious injury) risk per police-reported crash. Our analysis is based on three sets of data from five states (Florida, Illinois, Maryland, Missouri, and Pennsylvania): data on all police-reported crashes involving model year 2000 to 2004 vehicles; 2005 county-level vehicle registration data by vehicle model year and make/model; and odometer readings from vehicle emission inspection and maintenance (I/M) programs conducted in urban areas of four of the five states (Florida does not have an I/M program). The two measures of risk could differ for three reasons: casualty risks are different from fatality risk; risks per vehicle registration-year are different from risks per crash; and risks estimated from national data are different from risks from the five states analyzed here. We also examined the effect of driver behavior, crash location, and general vehicle design on risk, as well as sources of potential bias in using the crash data from five states.

  15. 昆山“8·2”爆炸事故存活伤员损伤特点及救治分析%Features of survived casualties and treatment strategies in Kunshan "August 2" explosion aaccident

    Institute of Scientific and Technical Information of China (English)

    刘军; 赵富丽; 吴健; 吴曙华; 杨爱祥; 李晓英; 彭霄; 常新; 程宏宇

    2015-01-01

    after the explosion accident on 2 August 2014 in Kunshan city,including 28 males and 12 females.(2) The major injury types included burn injury,inhalation injury,blast injury (lung,eye,eardrum,etc),traumatic brain injury and bone fractures.(3) All victims suffered from burn injury caused by the explosion.The mean burned extent in the survived victims accounted for (92 ± 14) % of total body surface (TBS) and the burned surface with Ⅲ degree accounted for (77 ± 19) % of TBS.Additionally,incidence of inhalation injury was 97.5%.(4) There were 34 victims were complicated by multiple organ dysfunction syndrome which accounted for 85.0%.The most common organ dysfunction of survived casualties included lungs,cardiovascular system,liver,gastrointestinal tract,kidney,and blood coagulation.(5) During hospitalization,the most common infectious site in survived casualties was burned skin,followed by blood and lung.The most common infectious strain of bacteria was Gram negative bacteria which accounted for 91.3%.Further analysis showed that Proteus mirabilis was leading pathogen,followed by Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumonia and Enterobacter cloacae.(6) After meticulous treatment,the mean 28-day mortality was 20.0% and 90-day mortality was 62.5%,mainly due to septic shock and multiple organ dysfunction syndrome.Conclusions During Kunshan "August 2" explosion accident,burn injury is the leading cause of injuries.Most of survived victims are accompanied by multiple organ dysfunction syndrome and infection.

  16. SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Yang, R; Wang, J [Peking University Third Hospital, Beijing, Beijing (China)

    2014-06-15

    Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, including 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy.

  17. Sign Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Union Slough National Wildlife Refuge Sign Plan explains how signs are used on the Refuge to help guide and educate visitors. An inventory of current signs is...

  18. Business Plan

    OpenAIRE

    Radošinská, Jana

    2014-01-01

    Diploma thesis deals with the processing of a business plan to establish a tour operator, which will offer tours to Puerto Rico. Thesis is divided into theoretical and practical part. The theoretical part explains what is business and related terms. Defines the tourism business and the procedure for the establishment of tour operators. There are also theoretically explained individual chapters of a business plan. The practical part is dedicated to the establishment of tour operator, where is ...

  19. Exposure to Suicide: Incidence and Association with Suicidal Ideation and Behavior: United States, 1994.

    Science.gov (United States)

    Crosby, Alex E.; Sacks, Jeffrey J.

    2002-01-01

    From a national random telephone survey of U.S. adults, estimates the 12-month incidence of exposure to suicide and its association with suicidal ideation, planning, and behavior. Of 5,238 respondents, 342 reported knowing a suicide decedent from the previous year. Univariate analysis showed persons reporting such exposure were significantly more…

  20. Incidence and predictors of coronary stent thrombosis

    DEFF Research Database (Denmark)

    D'Ascenzo, Fabrizio; Bollati, Mario; Clementi, Fabrizio;

    2013-01-01

    Stent thrombosis remains among the most feared complications of percutaneous coronary intervention (PCI) with stenting. However, data on its incidence and predictors are sparse and conflicting. We thus aimed to perform a collaborative systematic review on incidence and predictors of stent thrombo...

  1. Incidence of osteonecrosis after renal transplantation

    NARCIS (Netherlands)

    H.J. Metselaar (Herold); van Steenberge, J.P. (J. P.); A.B. Bijnen (Bart); J. Jeekel (Hans); B. van Linge (Bert); W. Weimar (Willem)

    1985-01-01

    textabstractThe incidence of osteonecrosis was 24% in 248 patients who had received 262 kidney transplants 1971-1982. However, based only on patients at risk, i.e. alive with functioning transplants, the incidence at 1, 3 and 6 years was found to be 13, 27 and 36%; after six years no new cases were

  2. Linux Incident Response Volatile Data Analysis Framework

    Science.gov (United States)

    McFadden, Matthew

    2013-01-01

    Cyber incident response is an emphasized subject area in cybersecurity in information technology with increased need for the protection of data. Due to ongoing threats, cybersecurity imposes many challenges and requires new investigative response techniques. In this study a Linux Incident Response Framework is designed for collecting volatile data…

  3. Critical Incidents in ELT Initial Teacher Training

    Science.gov (United States)

    Farrell, Thomas S. C.

    2008-01-01

    A critical incident is any unplanned event that occurs during class. In has been suggested that if trainee teachers formally reflect on these critical incidents, it may be possible for them to uncover new understandings of the teaching and learning process. This paper outlines and discusses how eighteen trainee teachers in an English language…

  4. 49 CFR 1542.307 - Incident management.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats,...

  5. The Incidence of Ankle Sprains in Orienteering.

    Science.gov (United States)

    Ekstrand, Jan; And Others

    1990-01-01

    Investigates relationship between ankle sprains and participation time in competitive orienteering. Examined 15,474 competitors in races in the Swedish O-ringen 5-day event in 1987. Injuries requiring medical attention were analyzed, showing 137 (23.9 percent) ankle sprains. Injury incidence was 8.4/10,000 hours. Incidence of ankle sprains was…

  6. Incidence and Epidemiology of Patellar Fractures

    DEFF Research Database (Denmark)

    Larsen, Peter; Court-Brown, Charles M; Vedel, Julie Odgaard;

    2016-01-01

    The literature lacks large-scale, up-to-date, population-based epidemiology studies on the incidence of patellar fractures based on complete populations. The purpose of this study was to provide up-to-date information concerning the incidence of patellar fractures in a large and complete population...

  7. How effective incident management retains market share.

    Science.gov (United States)

    Enright, Courtenay

    2012-01-01

    This paper discusses the need for business continuity practitioners to make incident management a focal element of their programme. Particularly during the first few minutes and hours of a business disruption, an established incident management methodology is not only key to achieving a successful, coordinated recovery, but it can play an even more important role in maintaining customer confidence following a disruption or crisis.

  8. Iraqi Civilian Casualties Estimates

    Science.gov (United States)

    2008-03-13

    Invasion of Iraq: Cluster Sample Survey,” The Lancet , October 29, 2004, 364 (9448), pp. 1857- 1864. 7 Jack Straw, Written U.K. Ministerial Statement...Health Study (the “WHO study”) March 2003 - June 2006 151,000 The Lancet , “Mortality after the 2003 Invasion of Iraq” March 19, 2003 - July 31, 2006...commonly referred to in the press as “ the Lancet studies” because they were published in the British medical journal of that name. The third study was

  9. Incidence of lead shot in canvasbacks

    Science.gov (United States)

    Perry, M.C.

    1976-01-01

    During 1975 and 1976, 2,544 canvasbacks (Aythya valisineria) from North Dakota, Wisconsin, Illinois, and Maryland were flouroscoped to determine the incidence of body shot. A significant increase from west to east was detected in the incidence of shot for immatures from the four states. The incidence of shot in immatures after the 1975-76 hunting season was 18 percent in Maryland and 20 percent in Illinois. In Wisconsin no difference in the incidence of shot could be detected between areas trapped or time periods when trapping was conducted. In Maryland a significant decrease in the incidence of body shot was detected in adults, but not immatures, between 1975 and 1976. shot was located throughout the body of canvasbacks. Frequency varied from one to nine shot per bird and averaged 2.0 for adults and 1.5 for immatures.

  10. Semantic Theme Analysis of Pilot Incident Reports

    Science.gov (United States)

    Thirumalainambi, Rajkumar

    2009-01-01

    Pilots report accidents or incidents during take-off, on flight and landing to airline authorities and Federal aviation authority as well. The description of pilot reports for an incident contains technical terms related to Flight instruments and operations. Normal text mining approaches collect keywords from text documents and relate them among documents that are stored in database. Present approach will extract specific theme analysis of incident reports and semantically relate hierarchy of terms assigning weights of themes. Once the theme extraction has been performed for a given document, a unique key can be assigned to that document to cross linking the documents. Semantic linking will be used to categorize the documents based on specific rules that can help an end-user to analyze certain types of accidents. This presentation outlines the architecture of text mining for pilot incident reports for autonomous categorization of pilot incident reports using semantic theme analysis.

  11. AN INCIDENCE STUDY OF SCHIZOPHRENIA IN INDIA

    Science.gov (United States)

    Wig, N.N.; Varma, Vijoy K.; Mattoo, S.K.; Behere, P.B.; Phookan, H.R.; Misra, A.K.; Murthy, R. Srinivasa; Tripathi, B.M.; Menon, D.K.; Khandelawal, S.K.; Bedi, H.

    1993-01-01

    SUMMARY Under a WHO collaborative study, the Chandigarh center monitored two geographically defined populations over a 2-year period. Using helping-agency-coverage and other methods along with a set of specified criteria, 268 first-onset potentially schizophrenic cases were actively identified. Of these, 232 cases could be assessed in detail which included 209 schizophrenics as per specified ICD-9 or Catego criteria. The annual incidence rates obtained were 4.4 and 3.8 per 10,000 for rural and urban areas, respectively. The rural cohort had a higher incidence for each of the three diagnostic definitions. In the urban cohort, sex and diagnostic definition did not affect the incidence. In the rural cohort, females had a lower incidence for Catego S+ and a higher incidence for other diagnostic definitions. PMID:21776160

  12. Integrating an incident management system within a continuity of operations programme: case study of the Bank of Canada.

    Science.gov (United States)

    Loop, Carole

    2013-01-01

    Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.

  13. 78 FR 38949 - Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response

    Science.gov (United States)

    2013-06-28

    ... specialized formats to communicate incident information? 5. What do you see as the pros and cons of... National Institute of Standards and Technology Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response AGENCY: National Institute of Standards and Technology, U.S. Department...

  14. Prototyping and validating requirements of radiation and nuclear emergency plan simulator

    Science.gov (United States)

    Hamid, AHA.; Rozan, MZA.; Ibrahim, R.; Deris, S.; Selamat, A.

    2015-04-01

    Organizational incapability in developing unrealistic, impractical, inadequate and ambiguous mechanisms of radiological and nuclear emergency preparedness and response plan (EPR) causing emergency plan disorder and severe disasters. These situations resulting from 65.6% of poor definition and unidentified roles and duties of the disaster coordinator. Those unexpected conditions brought huge aftermath to the first responders, operators, workers, patients and community at large. Hence, in this report, we discuss prototyping and validating of Malaysia radiation and nuclear emergency preparedness and response plan simulation model (EPRM). A prototyping technique was required to formalize the simulation model requirements. Prototyping as systems requirements validation was carried on to endorse the correctness of the model itself against the stakeholder's intensions in resolving those organizational incapability. We have made assumptions for the proposed emergency preparedness and response model (EPRM) through the simulation software. Those assumptions provided a twofold of expected mechanisms, planning and handling of the respective emergency plan as well as in bringing off the hazard involved. This model called RANEPF (Radiation and Nuclear Emergency Planning Framework) simulator demonstrated the training emergency response perquisites rather than the intervention principles alone. The demonstrations involved the determination of the casualties' absorbed dose range screening and the coordination of the capacity planning of the expected trauma triage. Through user-centred design and sociotechnical approach, RANEPF simulator was strategized and simplified, though certainly it is equally complex.

  15. [Childhood cancer: a comparative analysis of incidence, mortality, and survival in Goiania (Brazil) and other countries].

    Science.gov (United States)

    Braga, Patrícia Emília; Latorre Md, Maria do Rosário Dias de Oliveira; Curado, Maria Paula

    2002-01-01

    Analysis of cancer incidence, mortality, and survival rates can yield geographic and temporal trends that are useful for planning and evaluating health interventions. This article reviews cancer incidence and mortality rates and respective trends around the world in children under 15 years old, as well as their 5-year survival rates in developed and developing countries. We conclude that even though increasing or stable childhood cancer incidence rates and decreasing mortality rates have been observed in developed countries, the trends remain unknown in developing countries. Data from the city of Goiania, Brazil, show stable childhood cancer incidence and mortality rates. Five-year survival rates (48%) in Goiania are similar to those seen in underdeveloped regions and lower than those reported in developed countries (64-70%).

  16. Medical Technology Base Master Plan

    Science.gov (United States)

    1990-03-01

    action of candidate mnedical1 countermeasures - Analysis and characterization of candidate compounds and their inetabolites - Application of molecular ...expected that research in molecular biology will lead to medical ,.vphylaes and treatments that ofter improved speclicity and potency, thus increasing...Disease Hazards Research (Inlectious Disease, Medical Biologia Defense, and Military AIDS), Conbat Casualty Care Research, Medical Chem"ca Defense Research

  17. Increase of Prostate Cancer Incidence in Martinique

    Directory of Open Access Journals (Sweden)

    Dominique Belpomme

    2011-01-01

    Full Text Available Prostate cancer incidence is steadily increasing in many developed countries. Because insular populations present unique ethnic, geographical, and environmental characteristics, we analyzed the evolution of prostate cancer age-adjusted world standardized incidence rates in Martinique in comparison with that of metropolitan France. We also compared prostate cancer incidence rates, and lifestyle-related and socioeconomic markers such as life expectancy, dietary energy, and fat supply and consumption, with those in other Caribbean islands, France, UK, Sweden, and USA. The incidence rate of prostate cancer in Martinique is one of the highest reported worldwide; it is continuously growing since 1985 in an exponential mode, and despite a similar screening detection process and lifestyle-related behaviour, it is constantly at a higher level than in metropolitan France. However, Caribbean populations that are genetically close to that of Martinique have generally much lower incidence of prostate cancer. We found no correlation between prostate cancer incidence rates, life expectancy, and diet westernization. Since the Caribbean African descent-associated genetic susceptibility factor would have remained constant during the 1980–2005, we suggest that in Martinique some environmental change including the intensive use of carcinogenic organochlorine pesticides might have occurred as key determinant of the persisting highly growing incidence of prostate cancer.

  18. Scale invariance of incident size distributions in response to sizes of their causes.

    Science.gov (United States)

    Englehardt, James D

    2002-04-01

    Incidents can be defined as low-probability, high-consequence events and lesser events of the same type. Lack of data on extremely large incidents makes it difficult to determine distributions of incident size that reflect such disasters, even though they represent the great majority of total losses. If the form of the incident size distribution can be determined, then predictive Bayesian methods can be used to assess incident risks from limited available information. Moreover, incident size distributions have generally been observed to have scale invariant, or power law, distributions over broad ranges. Scale invariance in the distributions of sizes of outcomes of complex dynamical systems has been explained based on mechanistic models of natural and built systems, such as models of self-organized criticality. In this article, scale invariance is shown to result also as the maximum Shannon entropy distribution of incident sizes arising as the product of arbitrary functions of cause sizes. Entropy is shown by simulation and derivation to be maximized as a result of dependence, diversity, abundance, and entropy of multiplicative cause sizes. The result represents an information-theoretic explanation of invariance, parallel to those of mechanistic models. For example, distributions of incident size resulting from 30 partially dependent causes are shown to be scale invariant over several orders of magnitude. Empirical validation of power law distributions of incident size is reviewed, and the Pareto (power law) distribution is validated against oil spill, hurricane, and insurance data. The applicability of the Pareto distribution, in particular, for assessment of total losses over a planning period is discussed. Results justify the use of an analytical, predictive Bayesian version of the Pareto distribution, derived previously, to assess incident risk from available data.

  19. Natural Family Planning

    Science.gov (United States)

    ... Sex and Birth Control Birth Control Natural Family Planning Natural Family Planning Birth ControlPrevention and WellnessSex and Birth Control Share Natural Family Planning Natural Family PlanningWhat is natural family planning?Natural ...

  20. Incidence of ascariasis in gastric carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee [St Mary' s Hospital Catholic Medical College, Seoul (Korea, Republic of)

    1972-09-15

    Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides.

  1. Research and Development of a Convertible Use Rapidly Expandable Model for Response to Disasters and Mass Casualties

    Science.gov (United States)

    2009-10-01

    real time and in anticipation of future incidents. Information officers will be able to use the tool as a portal for information requests. AEGIS...will be able to use the tool as a portal for information requests. AEGIS will be able to quickly generate reports and summaries both for use in action...available to identify infectious agents Provide epidemic detection Biosurveillance and bio-agent detection Guidelines for the clinical recognition

  2. Birth Plans

    Science.gov (United States)

    ... These range from how you hope to handle pain relief to fetal monitoring. Think about the environment in which you ... include in your birth plan are preferences about fetal monitoring, extra ... during labor. Pain management. This is important for most women and ...

  3. Method paper--distance and travel time to casualty clinics in Norway based on crowdsourced postcode coordinates: a comparison with other methods.

    Directory of Open Access Journals (Sweden)

    Guttorm Raknes

    Full Text Available We describe a method that uses crowdsourced postcode coordinates and Google maps to estimate average distance and travel time for inhabitants of a municipality to a casualty clinic in Norway. The new method was compared with methods based on population centroids, median distance and town hall location, and we used it to examine how distance affects the utilisation of out-of-hours primary care services. At short distances our method showed good correlation with mean travel time and distance. The utilisation of out-of-hours services correlated with postcode based distances similar to previous research. The results show that our method is a reliable and useful tool for estimating average travel distances and travel times.

  4. Method paper--distance and travel time to casualty clinics in Norway based on crowdsourced postcode coordinates: a comparison with other methods.

    Science.gov (United States)

    Raknes, Guttorm; Hunskaar, Steinar

    2014-01-01

    We describe a method that uses crowdsourced postcode coordinates and Google maps to estimate average distance and travel time for inhabitants of a municipality to a casualty clinic in Norway. The new method was compared with methods based on population centroids, median distance and town hall location, and we used it to examine how distance affects the utilisation of out-of-hours primary care services. At short distances our method showed good correlation with mean travel time and distance. The utilisation of out-of-hours services correlated with postcode based distances similar to previous research. The results show that our method is a reliable and useful tool for estimating average travel distances and travel times.

  5. USCG Facility Pollution

    Data.gov (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  6. USCG Vessel

    Data.gov (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  7. USCG Other Events

    Data.gov (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  8. USCG Vessel Events

    Data.gov (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  9. USCG Vessel Pollution

    Data.gov (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  10. USCG Injury

    Data.gov (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  11. Oil Spill Incident Tracking [ds394

    Data.gov (United States)

    California Department of Resources — The Office of Spill Prevention and Response (OSPR) Incident Tracking Database is a statewide oil spill tracking information system. The data are collected by OSPR...

  12. Modelling and Simulation for Major Incidents

    Directory of Open Access Journals (Sweden)

    Eleonora Pacciani

    2015-11-01

    Full Text Available In recent years, there has been a rise in Major Incidents with big impact on the citizens health and the society. Without the possibility of conducting live experiments when it comes to physical and/or toxic trauma, only an accurate in silico reconstruction allows us to identify organizational solutions with the best possible chance of success, in correlation with the limitations on available resources (e.g. medical team, first responders, treatments, transports, and hospitals availability and with the variability of the characteristic of event (e.g. type of incident, severity of the event and type of lesions. Utilizing modelling and simulation techniques, a simplified mathematical model of physiological evolution for patients involved in physical and toxic trauma incident scenarios has been developed and implemented. The model formalizes the dynamics, operating standards and practices of medical response and the main emergency service in the chain of emergency management during a Major Incident.

  13. USFA NFIRS 2005 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2005 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  14. USFA NFIRS 2004 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2004 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  15. USFA NFIRS 1999 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 1999 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  16. USFA NFIRS 2000 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2000 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  17. USFA NFIRS 2002 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2002 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  18. USFA NFIRS 2001 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2001 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  19. USFA NFIRS 2007 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2007 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  20. USFA NFIRS 2006 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2006 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  1. USFA NFIRS 2009 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2009 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  2. USFA NFIRS 2008 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2008 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  3. USFA NFIRS 2003 Basic Fire Incident Data

    Data.gov (United States)

    Department of Homeland Security — The 2003 US Fire Administration Fire (USFA) Fire Incident & Cause Data was provided by the U.S. Fire Administration's (USFA) National Fire Data Center's (NFDC's)...

  4. Social monitoring research for predicting mass incidents

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Based on surveys of resident attitude, a social monitoring research team with the CAS Institute of Psychology has established a predicting model on the possibility of mass incidents, that is, collective conflicts against the administration.

  5. Incidence of tuberculosis in and around Banglore

    Directory of Open Access Journals (Sweden)

    K. L. Phaniraja

    2010-08-01

    Full Text Available Incidence of Tuberculosis is higher in developing countries due to absence of National control and Eradication programme. Incidence is higher due to close contact with infected animal or human being. In the present study, 2668 bovines were screened for tuberculosis by single intradermal test from 15 different organized government and private farm. Currently, the SID test is used worldwide to determine whether an animal is sensitized to Mycobacterial antigens or not and the test is approved by OIE. Out of which, incidence of 2.89% in HF cross breeds, 0.69% in Jersey cross bred animals and none were shown reactor to Single Intradermal test in Indigenous animals. The higher incidence of 3.26% was found in female and 0.48% found in male. The calves which were below two year of age were found 1.56% reactor. [Vet World 2010; 3(4.000: 161-164

  6. National Fire Incident Reporting System (NFIRS)

    Data.gov (United States)

    Department of Homeland Security — The National Fire Incident Reporting System (NFIRS) is a reporting standard that fire departments use to uniformly report on the full range of their activities, from...

  7. Standardized beam bouquets for lung IMRT planning

    Science.gov (United States)

    Yuan, Lulin; Wu, Q. Jackie; Yin, Fangfang; Li, Ying; Sheng, Yang; Kelsey, Christopher R.; Ge, Yaorong

    2015-02-01

    The selection of the incident angles of the treatment beams is a critical component of intensity modulated radiation therapy (IMRT) planning for lung cancer due to significant variations in tumor location, tumor size and patient anatomy. We investigate the feasibility of establishing a small set of standardized beam bouquets for planning. The set of beam bouquets were determined by learning the beam configuration features from 60 clinical lung IMRT plans designed by experienced planners. A k-medoids cluster analysis method was used to classify the beam configurations in the dataset. The appropriate number of clusters was determined by maximizing the value of average silhouette width of the classification. Once the number of clusters had been determined, the beam arrangements in each medoid of the clusters were designated as the standardized beam bouquet for the cluster. This standardized bouquet set was used to re-plan 20 cases randomly selected from the clinical database. The dosimetric quality of the plans using the beam bouquets was evaluated against the corresponding clinical plans by a paired t-test. The classification with six clusters has the largest average silhouette width value and hence would best represent the beam bouquet patterns in the dataset. The results shows that plans generated with a small number of standardized bouquets (e.g. 6) have comparable quality to that of clinical plans. These standardized beam configuration bouquets will potentially help improve plan efficiency and facilitate automated planning.

  8. Incidence and Mortality and Epidemiology of Breast Cancer in the World.

    Science.gov (United States)

    Ghoncheh, Mahshid; Pournamdar, Zahra; Salehiniya, Hamid

    2016-01-01

    Breast cancer is the most common malignancy in women around the world. Information on the incidence and mortality of breast cancer is essential for planning health measures. This study aimed to investigate the incidence and mortality of breast cancer in the world using age-specific incidence and mortality rates for the year 2012 acquired from the global cancer project (GLOBOCAN 2012) as well as data about incidence and mortality of the cancer based on national reports. It was estimated that 1,671,149 new cases of breast cancer were identified and 521,907 cases of deaths due to breast cancer occurred in the world in 2012. According to GLOBOCAN, it is the most common cancer in women, accounting for 25.1% of all cancers. Breast cancer incidence in developed countries is higher, while relative mortality is greatest in less developed countries. Education of women is suggested in all countries for early detection and treatment. Plans for the control and prevention of this cancer must be a high priority for health policy makers; also, it is necessary to increase awareness of risk factors and early detection in less developed countries.

  9. Energy planning and management plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-01-01

    This paper contains printed copies of 60FR 53181, October 12, 1995 and 60 FR 54151. This is a record of decision concerning the Western Area Power Administration`s final draft and environmental impact statement, and Energy Planning and Management Program.

  10. Plan Repair using a Plan Library

    NARCIS (Netherlands)

    Van der Krogt, R.P.J.; De Weerdt, M.M.

    2005-01-01

    Plan library's have proven their added value to the efficiency of planning. In this paper, we present results on the use of a plan library to plan repair. We show that using a relatively simple library, we can already obtain significant improvements in efficiency compared to plan repair without a li

  11. Comparative Incidence of Conformational, Neurodegenerative Disorders.

    Directory of Open Access Journals (Sweden)

    Jesús de Pedro-Cuesta

    Full Text Available The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs.We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD. We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD forms, amyotrophic lateral sclerosis (ALS, and sporadic rapidly progressing neurodegenerative dementia (sRPNDd. For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined.Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD, to 1589 and 2589 for AMD and Alzheimer's disease (AD respectively. Age-specific profiles varied from (a symmetrical, inverted V-shaped curves for low incidences to (b those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20-24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration.These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to incidence magnitude and survival might

  12. A COMPARATIVE ANALYSIS OF INCIDENT SERVICE TIME ON URBAN FREEWAYS

    Directory of Open Access Journals (Sweden)

    Hyung Jin KIM, Ph.D.

    2001-01-01

    In this study, a fuzzy incident response model is formulated in terms of incident, type of vehicle, type of incident vehicle, location of incident vehicle, and incident service time. In order to analyze the reliability of the proposed model, the application of the model is made using the actual incident data collected on the freeway in the Los Angeles area. The application of the model shows that the fuzzy incident response system is very effective in describing the actual judgment of the incident operators in terms of incident service time.

  13. Psychological impact and recovery after involvement in a patient safety incident: a repeated measures analysis

    Science.gov (United States)

    Van Gerven, Eva; Bruyneel, Luk; Panella, Massimiliano; Euwema, Martin; Sermeus, Walter; Vanhaecht, Kris

    2016-01-01

    Objective To examine individual, situational and organisational aspects that influence psychological impact and recovery of a patient safety incident on physicians, nurses and midwives. Design Cross-sectional, retrospective surveys of physicians, midwives and nurses. Setting 33 Belgian hospitals. Participants 913 clinicians (186 physicians, 682 nurses, 45 midwives) involved in a patient safety incident. Main outcome measures The Impact of Event Scale was used to retrospectively measure psychological impact of the safety incident at the time of the event and compare it with psychological impact at the time of the survey. Results Individual, situational as well as organisational aspects influenced psychological impact and recovery of a patient safety incident. Psychological impact is higher when the degree of harm for the patient is more severe, when healthcare professionals feel responsible for the incident and among female healthcare professionals. Impact of degree of harm differed across clinicians. Psychological impact is lower among more optimistic professionals. Overall, impact decreased significantly over time. This effect was more pronounced for women and for those who feel responsible for the incident. The longer ago the incident took place, the stronger impact had decreased. Also, higher psychological impact is related with the use of a more active coping and planning coping strategy, and is unrelated to support seeking coping strategies. Rendered support and a support culture reduce psychological impact, whereas a blame culture increases psychological impact. No associations were found with job experience and resilience of the health professional, the presence of a second victim support team or guideline and working in a learning culture. Conclusions Healthcare organisations should anticipate on providing their staff appropriate and timely support structures that are tailored to the healthcare professional involved in the incident and to the specific

  14. Incidence of gastrointestinal parasitism of captive wild pigeons at Nagpur

    Directory of Open Access Journals (Sweden)

    A. T. Borghare

    Full Text Available Present study was planned to investigate the helminthic infection in captive wild pigeons (Columba livia at Maharajbagh Zoo Nagpur. All the 30 samples examined were found positive either with single or mixed helminthic infections. The result showed that the incidence of Capillaria sp, Ascaridia sp and  Hetarakis sp. were 56.66%, 76.66%, 16.66% respectively. Mixed parasitic infection was recorded in around 17 samples with either Ascaridia sp. and Capillaria sp or with Ascaridia sp. and Heterakis sp. One of 30 samples examined were found with the cysts of Balantidium coli. [Vet World 2009; 2(9.000: 343-

  15. Choropleth Map Design for Cancer Incidence, Part 2

    Directory of Open Access Journals (Sweden)

    Thomas B. Richards, MD

    2010-01-01

    Full Text Available Choropleth maps are commonly used in cancer reports and community discussions about cancer rates. Cancer registries increasingly use geographic information system techniques. The Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control convened a Map Work Group to help guide application of geographic information system mapping techniques and to promote choropleth mapping of data from central cancer registries supported by the National Program of Cancer Registries, especially for comprehensive cancer control planning and evaluation purposes. In this 2-part series, we answer frequently asked questions about choropleth map design to display cancer incidence data. We recommend that future initiatives consider more advanced mapping, spatial analysis, and spatial statistics techniques and include usability testing with representatives of state and local programs and other cancer prevention partners.

  16. Choropleth Map Design for Cancer Incidence, Part 1

    Directory of Open Access Journals (Sweden)

    Thomas B. Richards, MD

    2010-01-01

    Full Text Available Choropleth maps are commonly used in cancer reports and community discussions about cancer rates. Cancer registries increasingly use geographic information system techniques. The Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control convened a Map Work Group to help guide application of geographic information systems mapping techniques and to promote choropleth mapping of data from central cancer registries supported by the National Program of Cancer Registries, especially for planning and evaluation of comprehensive cancer control programs. In this 2-part series in this issue of Preventing Chronic Disease, we answer frequently asked questions about choropleth map design to display cancer incidence data. We recommend that future initiatives consider more advanced mapping, spatial analysis, and spatial statistics techniques, and include usability testing with representatives of state and local programs and other cancer prevention partners.

  17. Investigation of the hydrogen release incident at the AC Transit Emeryville Facility.

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Aaron P.; San Marchi, Christopher W.; Levin, Jamie; Butler, Dennis

    2012-06-01

    This report summarizes the investigation of the release of approximately 300kg of hydrogen at the AC Transit Facility in Emeryville, CA. The hydrogen release was avoidable in both the root cause and contributing factors. The report highlights the need for communication in all phases of project planning and implementation. Apart from the failed valve, the hydrogen system functioned as designed, venting the hydrogen gas a safe distance above surrounding structures and keeping the subsequent fire away from personnel and equipment. The Emeryville Fire Department responded appropriately given the information provided to the Incident Commander. No injuries or fatalities resulted from the incident.

  18. Multiemployer Pension Plans

    Data.gov (United States)

    Pension Benefit Guaranty Corporation — This spreadsheet lists the active multiemployer pensions plans insured by PBGC. Plans are identified by name, employer identification number (EIN) and plan number...

  19. Nursing care of children after a traumatic incident

    Directory of Open Access Journals (Sweden)

    Konstantinos Nakakis

    2013-04-01

    Full Text Available Childhood experiences of living in a world of sweeping changes and unpredictable extreme events can be very stressful and are often traumatic and children are not able to mobilize the defense mechanisms necessary for adaptation. Traumatic experiences for a child can include exposure to natural disasters, circumstances such as war and terrorism, situations of victimization (physical or sexual abuse, accidents resulting in serious injury and disability, loss of loved one, a life-threatening illness and hospitalizations, painful situations, as well as domestic and interfamily violence. The aim of this literature review was to explore the nursing care of children after a traumatic incident through a critical review of the existing literature. Material and Methods: A literature search was performed in Medline, Cinahl, BNI, PsycINFO, and Scopus databases with keywords relevant to the subject of this review. Results: From the literature review it was found that the published resources with respect to the nursing care of children after a traumatic event are very limited and they do not provide clear nursing care plans. Nursing care of children after a traumatic incident involves the prevention of trauma, the detection of early symptoms, the protection of the child from self-destructive and suicidal behavior, the restoration of confidence in self and others, the enhancement of the expressiveness, covering child's emotional needs, the family counseling and reconnection with their peers and childhood activities, as well as ensuring follow-up of their therapeutic progress. Conclusions: Traumatic experiences directly influence a child at physical, mental and emotional levels, making an impact on the smooth psycho-emotional development, the formation of his personality and the quality of childhood and future adult life. It is vital that nurses are aware of therapeutic techniques, in order to approach and nurse traumatized children in the community or in

  20. INCIDENCE AND CLINICAL FEATURES OF SNAKEBITE CELLULITIS AT KIMS, HUBLI

    Directory of Open Access Journals (Sweden)

    Chetan

    2014-12-01

    Full Text Available BACKGROUND: A single centre study was planned to asses the incidence and clinical feature of snake bite cellulitis in order to find out the nature and burden of the disease. OBJECTIVES: To assess incidence and clinical features of snake bite cellulitis. METHODOLOGY: This present one year prospective study was conducted in the Department of Surgery, Karnataka Institute of Medical Sciences, Hubli. Out of 520 total cases of snake bites 66 patients with cellulitis changes were studied. STATISTICAL ANALYSIS: The data obtained was coded and entered in Microsoft Excel Spreadsheet. The categorical data was expressed as rates, ratios and percentages. RESULTS: Out of 520 total snake bite cases, 66 patients developed signs of cellulitis. In patients with cellulitis 49(74.24% were males and 17(25.75% were females. In patients with cellulitis, most were aged between 31 to 45 years (36.36% and 19 to 30 years (34.84.The mean age of the study population was 32.43 ± 13.75 years. Majority of the patients (74.24% had snake bite on lower limbs. Most common symptom complex noted was pain + swelling in 30(39.39% of the patients followed by pain in 9(13.6%, swelling in 6(9%, pain+swelling+fever in 4(6%, pain + discolouration in 2(3% and pain + fever in 1(1.5% of the patients. CONCLUSIONS: The present study shows high incidence of cellulitis in patients with snake bite and most common clinical feature is cellulitis is pain + swelling. So in any case of snake of snake bite we should take the proper precautionary measures to prevent cellulitis. If cellulitis has already formed, then it should be treated without delay in order to prevent limb loss, compartment syndrome, other morbidities and even death.

  1. LPI studies with grazing incidence irradiation at the Nike laser

    Science.gov (United States)

    Weaver, J.; Kehne, D.; Schmitt, A.; Obenschain, S.; Serlin, V.; Oh, J.; Lehmberg, R.; Seely, J.

    2013-10-01

    Studies of laser plasma instabilities (LPI) at the Nike laser facility at NRL have previously concentrated on planar targets irradiated with their surface normal aligned to the central axis of the laser. Shots with planar targets rotated up 60° to the laser have shown changes in thresholds for the two-plasmon decay instability and stimulated Raman scattering near the quarter critical region. In the case of rotated low-Z targets, spectra were observed to shift to lower wavelength and were substantially stronger in the visible and ultraviolet spectral ranges. The low-Z target data show growth at an incident intensity slightly below (~30%) the threshold values observed at normal incidence. A rapid rise in signal level over the same laser intensities was also observed in the hard x-ray data which serve as an overall indicator of LPI activity. Shots with rotated planar high-Z targets showed that the visible and ultraviolet emissions dropped significantly when compared to low-Z targets in the same geometry. This presentation will include results from upcoming experiments to determine the LPI signal for low-Z, high-Z, and high-Z coated targets at lower laser intensities for several angles of target rotation. Shots with widely separated laser beams are also planned to explore cross beam energy transport at Nike. Work supported by DoE/NNSA.

  2. Incidence and overall survival of malignant ameloblastoma.

    Directory of Open Access Journals (Sweden)

    Alexandra Rizzitelli

    Full Text Available Malignant ameloblastoma, comprising metastasizing ameloblastoma and ameloblastic carcinoma, represents 1.6-2.2% of all odontogenic tumors. Due to its rare nature, malignant ameloblastoma has only been reported in the literature in small case series or case reports. Using the Surveillance, Epidemiology and End-Results (SEER database, we have performed a population-based study to determine the incidence rate and the absolute survival of malignant ameloblastoma.Using the International Classification of Diseases for Oncology (ICD-O codes 9310/3 and 9270/3, data from the SEER database were used to calculate the incidence rate and absolute survival rate of population with malignant ameloblastoma.The overall incidence rate of malignant ameloblastoma was 1.79 per 10 million person/year. The incidence rate was higher in males than females and also higher in black versus white population. The median overall survival was 17.6 years from the time of diagnosis and increasing age was associated with a statistically significant poorer survival.To our best knowledge, we report the largest population-based series of malignant ameloblastoma. The incidence rate was 1.79 per 10 million person/year and the overall survival was 17.6 years.

  3. Estimating the incidence of the acute coronary syndrome: data from a Danish cohort of 138 290 persons

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Melgaard; Foldspang, Anders; Larsen, Mogens Lytken

    2007-01-01

    of identification and control of the cohort under observation, (iii) inconsistencies in the use of diagnostic criteria, and (iv) missing data. We aimed to measure directly the incidence of the entire spectrum of the acute coronary syndrome (ACS), consisting of unstable angina pectoris, MI and sudden cardiac death......BACKGROUND: Estimates of incidence are crucial to the planning of public health measures, but most studies of incidence of, for example, acute myocardial infarction (MI) are troubled by methodological problems such as; (i) selection biases of the patients being included for study, (ii) lack...

  4. Care plan for prediabetic patients

    Directory of Open Access Journals (Sweden)

    Marina Nieves Pino Escudero

    2013-09-01

    Full Text Available Diabetes Mellitus type 2 has a growing impact in the survival and well-being of the population. In recent years its incidence has progressively increased at an alarming rate. However, there are some modifiable risks factors directly related with life styles. Nurse plays a fundamental role in the identification of such factors as well as promoting healthy habits for the prevention of the Diabetes Mellitus type 2.This works presents a standardized care plan for prediabetic state, for this, it had been used the NANDA, NOC, NIC classifications.

  5. Hepatitis B prevalence and incidence in Greenland

    DEFF Research Database (Denmark)

    Børresen, Malene Landbo; Andersson, Mikael; Wohlfahrt, Jan

    2015-01-01

    Greenland remains a highly endemic area for hepatitis B virus (HBV) infection. This is in sharp contrast to other modern societies, such as Denmark. To address this discrepancy, we investigated the natural history of HBV infection in Greenland by estimating the age-specific incidence of HBV...... infection, the proportion of chronic carriers, and the rates of hepatitis B surface antigen seroclearance. In total, 8,879 Greenlanders (16% of the population) from population-based surveys conducted in 1987 and 1998 were followed through March 2010. Data on HBV status were supplemented by HBV test results...... from all available HBV registries in Greenland to determine changes in HBV status over time. Incidence rates of HBV infection and hepatitis B surface antigen seroclearance were estimated after taking into account interval censoring. The incidence of HBV infection in 5-14-year-old subjects was less than...

  6. Incidence and prevalence of epilepsy in Denmark

    DEFF Research Database (Denmark)

    Christensen, Jakob; Vestergaard, Mogens; Pedersen, Marianne G;

    2007-01-01

    PURPOSE: To estimate the occurrence of epilepsy in Denmark between 1977 and 2002, taking gender, age, and secular trends into consideration. METHODS: We used the Danish Civil Registration System to identify all persons born in Denmark and the Danish National Hospital Register to identify persons...... registered with epilepsy between 1977 and 2002. RESULTS: Between 1977 and 2002 the average incidence of epilepsy was 68.8 new epilepsy patients per 100,000 person-years at risk. However, the incidence changed with calendar time and increased steeply from 1990 to 1995, probably due to changes in diagnostic...... declined from a high level in children to a low level between 20 and 40 years of age, and thereafter a gradual increase was seen. The incidence rate was slightly higher in men than in women except for the age range 10-20 years. About 2% of the population was diagnosed with epilepsy at some point during...

  7. Planning your pregnancy

    Science.gov (United States)

    ... Pregnancy > Before or between pregnancies > Planning your pregnancy Planning your pregnancy E-mail to a friend Please ... partner as you start your family. Why is planning your pregnancy important? Planning your pregnancy can help ...

  8. Planning Inequality

    DEFF Research Database (Denmark)

    Mandersheid, Katharina; Richardson, Tim

    2011-01-01

    around particular spatial imaginaries. In an analysis of the German Spatial Planning Report, the paper examines how inequalities are represented in relation to space and movement in spatial strategy. The analysis shows how, in the report, the spatial dimension of the social is represented...... as a territorial container, in which the social merges into regional and national entities. Correspondingly, movement is only interpreted as a derived demand, ignoring its integrative aspect as precondition of participation and part of network capital. On the other hand, the spatiality of the economy...

  9. Current cancer incidence and trends in Yaounde, Cameroon

    Directory of Open Access Journals (Sweden)

    Enow Orock GE

    2014-05-01

    Full Text Available Background: Except for some information on relative frequencies of different cancers in selected areas, the epidemiology of cancer in Cameroon is relatively unknown. Though there is no reliable data on its incidence and pattern, with an estimated 15,000 new cases diagnosed annually and a prevalence of about 25.000 cases throughout the country, cancer is being increasingly recognized as a public health problem in Cameroon. The Yaounde Cancer Registry is a population registry physically located at the General Hospital Yaounde that has been operating since 2004. It collects data from about 20 sources that cover the entire population of Yaounde estimated in 2010 at about 1,299,369. Objectives: The objective of this study was to find out the incidence and trends of cancer in the Yaounde population in the period 2004 – 2006/2010 – 2011. It is hoped that this will enable policy makers, health providers and other stake holders plan appropriate health management policy in this population. Materials and Methods: This report presents the cancer incidence for 5 years, 2004 – 2006/2010 – 2011 in the Yaounde population estimated at 1,299,369. Data of the Yaounde Cancer Registry was reviewed for the period under study using Canreg5 software. Only malignant cases registered during the period under study were used in the analysis while benign and other uncertain tumours were excluded. The 2010 census estimates by the National Institute of Statistics was employed to calculate the incidence, age-standardized and crude rates. Other software like excel, epi info were also used for analysis. Survival studies were not carried out in this study. Results: A total of 4,689 new malignant cases were reported, of which 2,901 (68% were females and 1,788 (32% were males. The incidence showed an average of 358 for men and 580 for women. The average age of cancer patients in Yaounde is 44.8 years. Morphologically confirmed cases accounted for 89% .The annual number of

  10. Cancer incidence among Nordic airline cabin crew.

    Science.gov (United States)

    Pukkala, Eero; Helminen, Mika; Haldorsen, Tor; Hammar, Niklas; Kojo, Katja; Linnersjö, Anette; Rafnsson, Vilhjálmur; Tulinius, Hrafn; Tveten, Ulf; Auvinen, Anssi

    2012-12-15

    Airline cabin crew are occupationally exposed to cosmic radiation and jet lag with potential disruption of circadian rhythms. This study assesses the influence of work-related factors in cancer incidence of cabin crew members. A cohort of 8,507 female and 1,559 male airline cabin attendants from Finland, Iceland, Norway and Sweden was followed for cancer incidence for a mean follow-up time of 23.6 years through the national cancer registries. Standardized incidence ratios (SIRs) were defined as ratios of observed and expected numbers of cases. A case-control study nested in the cohort (excluding Norway) was conducted to assess the relation between the estimated cumulative cosmic radiation dose and cumulative number of flights crossing six time zones (indicator of circadian disruption) and cancer risk. Analysis of breast cancer was adjusted for parity and age at first live birth. Among female cabin crew, a significantly increased incidence was observed for breast cancer [SIR 1.50, 95% confidence interval (95% CI) 1.32-1.69], leukemia (1.89, 95% CI 1.03-3.17) and skin melanoma (1.85, 95% CI 1.41-2.38). Among men, significant excesses in skin melanoma (3.00, 95% CI 1.78-4.74), nonmelanoma skin cancer (2.47, 95% CI 1.18-4.53), Kaposi sarcoma (86.0, 95% CI 41.2-158) and alcohol-related cancers (combined SIR 3.12, 95% CI 1.95-4.72) were found. This large study with complete follow-up and comprehensive cancer incidence data shows an increased incidence of several cancers, but according to the case-control analysis, excesses appear not to be related to the cosmic radiation or circadian disruptions from crossing multiple time zones.

  11. Recording pressure ulcer risk assessment and incidence.

    Science.gov (United States)

    Plaskitt, Anne; Heywood, Nicola; Arrowsmith, Michaela

    2015-07-15

    This article reports on the introduction of an innovative computer-based system developed to record and report pressure ulcer risk and incidence at an acute NHS trust. The system was introduced to ensure that all patients have an early pressure ulcer risk assessment, which prompts staff to initiate appropriate management if a pressure ulcer is detected, thereby preventing further patient harm. Initial findings suggest that this electronic process has helped to improve the timeliness and accuracy of data on pressure ulcer risk and incidence. In addition, it has resulted in a reduced number of reported hospital-acquired pressure ulcers.

  12. Rising incidence of Merkel cell carcinoma

    DEFF Research Database (Denmark)

    Lyhne, Dorte; Lock-Andersen, Jørgen; Dahlstrøm, Karin;

    2011-01-01

    Abstract Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark, and to investi......Abstract Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark...

  13. Predicting Cumulative Incidence Probability by Direct Binomial Regression

    DEFF Research Database (Denmark)

    Scheike, Thomas H.; Zhang, Mei-Jie

    Binomial modelling; cumulative incidence probability; cause-specific hazards; subdistribution hazard......Binomial modelling; cumulative incidence probability; cause-specific hazards; subdistribution hazard...

  14. Hazmat 10 Year Incident Summary Reports - Data Mining Tool

    Data.gov (United States)

    Department of Transportation — Series of Incident data and summary statistics reports produced which provide statistical information on incidents by type, year, geographical location, and others....

  15. Hazmat Yearly Incident Summary Reports - Data Mining Tool

    Data.gov (United States)

    Department of Transportation — Series of Incident data and summary statistics reports produced which provide statistical information on incidents by type, year, geographical location, and others....

  16. Real-time Detection of Road Traffic Incidents

    Directory of Open Access Journals (Sweden)

    Pero Škorput

    2010-07-01

    KEY WORDS: intelligent transport system, incident management system, traffic model in the status space, theory of estimation, extended Kalman filter, automatic incident detection, decision support system

  17. Development of adjustable grazing incidence optics for Generation-X

    Science.gov (United States)

    Reid, Paul B.; Murray, Stephen S.; Trolier-McKinstry, Susan; Freeman, Mark; Juda, Michael; Podgorski, William; Ramsey, Brian; Schwartz, Daniel

    2008-07-01

    For X-ray astronomy, 0.1 arc-second imaging resolution will result in a significant advance in our understanding of the Universe. Similarly, the advent of low cost high performance X-ray mirrors will also increase the likelihood of more X-ray telescopes being funded and built. We discuss the development plans of two different types of adjustable grazing incidence optics: one being a tenth arc-second resolution bimorph mirror approach also suitable for extremely large collecting areas, and the second being a few arc-second radially adjustable mirror approach more suitable for modest sized telescopes. Bimorph mirrors will be developed using thin (0.1 - 0.4 mm) thermally formed glass or electroplated metal mirror segments with thin film piezo-electric actuators deposited directly on the mirror back surface. Mirror figure will be adjusted on-orbit. Radially adjustable mirrors will employ discreet radially electrostrictive actuators for mirror alignment and low spatial error frequency figure correction during assembly and alignment. In this paper we report on. In this paper we describe mirror design and our development plans for both mirror concepts.

  18. Fukushima nuclear incident: the challenges of risk communication.

    Science.gov (United States)

    Robertson, Andrew G; Pengilley, Andrew

    2012-07-01

    On March 11, 2011, a magnitude 9.0 earthquake occurred off the Sanriku coast of Japan, which resulted in multiple tsunamis. The earthquake and tsunami damaged several nuclear power stations, with the Fukushima Dai-ichi Nuclear Power Plant being the worst affected, which led Japan to declare a State of Nuclear Emergency. As of November 9, 2011, the National Police Agency of Japan reported a death toll of 15 836 people, with 3664 people still reported missing, following the earthquake and tsunami. Australian radiation health advisers were deployed to Tokyo early in the nuclear emergency to assist the Australian Embassy in assessing the radiological threat, to provide risk advice to Embassy staff and Australian citizens in Japan, and to plan for any further deterioration in the nuclear situation. This article explores the challenges of risk assessment, risk communication, and contingency planning for expatriate staff in the worst nuclear incident since Chernobyl, outlines what measures were successful in addressing heightened perceived risks, and identifies areas where further research is required, particularly in a radiological context.

  19. Risk Assessment Using The Homeland-Defense Operational Planning System (HOPS)

    Energy Technology Data Exchange (ETDEWEB)

    Durling, R L; Price, D E; Spero, K K

    2005-06-06

    For over ten years, the Counterproliferation Analysis and Planning System (CAPS) at Lawrence Livermore National Laboratory (LLNL) has been a planning tool used by U.S. combatant commands for mission support planning against foreign programs engaged in the manufacture of weapons of mass destruction (WMD). CAPS is endorsed by the Secretary of Defense as the preferred counterproliferation tool to be used by the nation's armed services. A sister system, the Homeland-Defense Operational Planning System (HOPS), is a new operational planning tool leveraging CAPS expertise designed to support the defense of the U.S. homeland. HOPS provides planners with a basis to make decisions to protect against acts of terrorism, focusing on the defense of facilities critical to U.S. infrastructure. Criticality of facilities, structures, and systems is evaluated on a composite matrix of specific projected casualty, economic, and sociopolitical impact bins. Based on these criteria, significant unidentified vulnerabilities are identified and secured. To provide insight into potential successes by malevolent actors, HOPS analysts strive to base their efforts mainly on unclassified open-source data. However, more cooperation is needed between HOPS analysts and facility representatives to provide an advantage to those whose task is to defend these facilities. Evaluated facilities include: refineries, major ports, nuclear power plants and other nuclear licensees, dams, government installations, convention centers, sports stadiums, tourist venues, and public and freight transportation systems. A generalized summary of analyses of U.S. infrastructure facilities will be presented.

  20. Vulnerability And Risk Assessment Using The Homeland-Defense Operational Planning System (HOPS)

    Energy Technology Data Exchange (ETDEWEB)

    Durling, Jr., R L; Price, D E; Spero, K K

    2005-01-03

    For over ten years, the Counterproliferation Analysis and Planning System (CAPS) at Lawrence Livermore National Laboratory (LLNL) has been a planning tool used by U.S. combatant commands for mission support planning against foreign programs engaged in the manufacture of weapons of mass destruction (WMD). CAPS is endorsed by the Secretary of Defense as the preferred counterproliferation tool to be used by the nation's armed services. A sister system, the Homeland-Defense Operational Planning System (HOPS), is a new operational planning tool leveraging CAPS expertise designed to support the defense of the U.S. homeland. HOPS provides planners with a basis to make decisions to protect against acts of terrorism, focusing on the defense of facilities critical to U.S. infrastructure. Criticality of facilities, structures, and systems is evaluated on a composite matrix of specific projected casualty, economic, and sociopolitical impact bins. Based on these criteria, significant unidentified vulnerabilities are identified and secured. To provide insight into potential successes by malevolent actors, HOPS analysts strive to base their efforts mainly on unclassified open-source data. However, more cooperation is needed between HOPS analysts and facility representatives to provide an advantage to those whose task is to defend these facilities. Evaluated facilities include: refineries, major ports, nuclear power plants and other nuclear licensees, dams, government installations, convention centers, sports stadiums, tourist venues, and public and freight transportation systems. A generalized summary of analyses of U.S. infrastructure facilities is presented.

  1. Design of neutral particle incident heating apparatus for large scale helical apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, Osamu; Oka, Yoshihide; Osakabe, Masaki; Takeiri, Yasuhiko; Tsumori, Katsuyoshi; Akiyama, Ryuichi; Asano, Eiji; Kawamoto, Toshikazu; Kuroda, Tsutomu [National Inst. for Fusion Science, Nagoya (Japan)

    1997-02-01

    In the Institute of Nuclear Fusion Science, construction of the large scale helical apparatus has been progressed favorably, and constructions of the heating apparatus as well as of electron resonance apparatus were begun in their orders under predetermined manner since 1994 fiscal year. And, on 1995 fiscal year, construction of neutral particle incident heating apparatus, leading heat apparatus, was begun under 3 years planning. The plasma heating study system adopted the study results developed in this institute through the large scale hydrogen negative ion source and also adopted thereafter development on nuclear fusion study by modifying the original specification set at the beginning of the research plan before 7 years. As a result, system design was changed from initial 125 KeV to 180 KeV in the beam energy and to execute 15 MW incidence using two sets beam lines, to begin its manufacturing. Here is described on its new design with reason of its modifications. (G.K.)

  2. Creating an African HIV clinical research and prevention trials network: HIV prevalence, incidence and transmission.

    Directory of Open Access Journals (Sweden)

    Anatoli Kamali

    Full Text Available HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner.

  3. Trip-timing decisions with traffic incidents

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Lindsey, Robin

    2013-01-01

    This paper analyzes traffic bottleneck congestion when drivers randomly cause incidents that temporarily block the bottleneck. Drivers have general scheduling preferences for time spent at home and at work. They independently choose morning departure times from home to maximize expected utility...

  4. Incidence angle normalization of radar backscatter data

    Science.gov (United States)

    NASA’s Soil Moisture Passive Active (SMAP) satellite (~2014) will include a radar system that will provide L-band multi-polarization backscatter at a constant incidence angle of 40º. During the pre-launch phase of the project there is a need for observations that will support the radar-based soil mo...

  5. Taken with Surprise: Critical Incidents in Teaching

    Science.gov (United States)

    Pui-Lan, Kwok; Brown, William P.; Delamarter, Steve; Frank, Thomas E.; Marshall, Joretta L.; Menn, Esther; Riggs, Marcia Y.

    2005-01-01

    This collection of essays tackles thorny questions related to critical incidents in teaching. By using different pedagogical methods and techniques, each author provokes creative thinking about how to address specific concerns common to teaching. The authors demonstrate that the teaching and learning process must make room for--if not…

  6. Barriers to learning from incidents and accidents

    NARCIS (Netherlands)

    Dechy, N.; Dien, Y.; Drupsteen, L.; Felicio, A.; Cunha, C.; Roed-Larsen, S.; Marsden, E.; Tulonen, T.; Stoop, J.; Strucic, M.; Vetere Arellano, A.L.; Vorm, J.K.J. van der; Benner, L.

    2015-01-01

    This document provides an overview of knowledge concerning barriers to learning from incidents and accidents. It focuses on learning from accident investigations, public inquiries and operational experience feedback, in industrial sectors that are exposed to major accident hazards. The document disc

  7. Incident Investigation in SMS and FRMS

    NARCIS (Netherlands)

    Stewart, S.; Koornneef, F.; Akselsson, R.; Kingston, J.; Stewart, D.

    2009-01-01

    Chapter 4: Incident Investigation in SMS and FRMS The European Commission HILAS project (Human Integration into the Lifecycle of Aviation Systems - a project supported by the European Commission’s 6th Framework between 2005-2009) was focused on using human factors knowledge and methodology to addre

  8. Lunar Tractive Forces and Renal Stone Incidence

    Directory of Open Access Journals (Sweden)

    Spyridon Arampatzis

    2011-01-01

    Full Text Available Background. Several factors are implicated in renal stone formation and peak incidence of renal colic admissions to emergency departments (ED. Little is known about the influence of potential environmental triggers such as lunar gravitational forces. We conducted a retrospective study to test the hypothesis that the incidence of symptomatic renal colics increases at the time of the full and new moon because of increased lunar gravitational forces. Methods. We analysed 1500 patients who attended our ED between 2000 and 2010 because of nephrolithiasis-induced renal colic. The lunar phases were defined as full moon ± 1 day, new moon ± 1 day, and the days in-between as “normal” days. Results. During this 11-year period, 156 cases of acute nephrolithiasis were diagnosed at the time of a full moon and 146 at the time of a new moon (mean of 0.4 per day for both. 1198 cases were diagnosed on “normal” days (mean 0.4 per day. The incidence of nephrolithiasis in peak and other lunar gravitational phases, the circannual variation and the gender-specific analysis showed no statistically significant differences. Conclusion. In this adequate powered longitudinal study, changes in tractive force during the different lunar phases did not influence the incidence of renal colic admissions in emergency department.

  9. Preparing for major incidents in Kenya

    Directory of Open Access Journals (Sweden)

    B.W. Wachira*

    2013-12-01

    This report provides a review of some of the major incidents in Kenya for the period 2000–2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.

  10. IT Security Vulnerability and Incident Response Management

    NARCIS (Netherlands)

    Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.

    2006-01-01

    This paper summarises the results of a Dutch PhD research project on IT security vulnerability and incident response management, which is supervised by the University of Twente in the Netherlands and which is currently in its final stage. Vulnerabilities are ‘failures or weaknesses in computer (appl

  11. Urbanisation and the incidence of eating disorders.

    NARCIS (Netherlands)

    Son, G.E. van; Hoeken, D. van; Bartelds, A.I.M.; Furth, E.F. van; Hoek, H.W.

    2006-01-01

    The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose response relati

  12. Urbanisation and the incidence of eating disorders

    NARCIS (Netherlands)

    Van Son, Gabrielle E.; Van Hoeken, Daphne; Bartelds, Aad I. M.; Van Furth, Eric F.; Hoek, Hans W.

    2006-01-01

    The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose-response relati

  13. The incidence of anorexia nervosa on Curacao

    NARCIS (Netherlands)

    Hoek, HW; van Harten, PN; Hermans, KME; Katzman, MA; Matroos, GE; Susser, ES

    2005-01-01

    Objective: Although anorexia nervosa was once thought to occur only in affluent societies, cases have now been documented across the globe. To examine whether anorexia nervosa emerges in societies undergoing socioeconomic transition, the authors studied the incidence of anorexia nervosa on the Carib

  14. Incident response monitoring technologies for aircraft cabin

    NARCIS (Netherlands)

    Havermans, J.B.G.A.; Houtzager, M.M.G.; Jacobs, P.

    2015-01-01

    The Netherlands Organization for Applied Scientific Research (TNO) was granted by ASHRAE (1306-RP) to conduct scientfic review and feasibility analysis of technologies and methods for measuring aircraft power system contaminants in the cabin air during unanticipated adverse incidents. In particular,

  15. Incidence, etiology and mortality of cirrhosis

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Schaffalitzky de Muckadell, Ove B; Touborg Lassen, Annmarie

    2012-01-01

    Knowledge on the prognosis among patients with cirrhosis is mainly based on clinical trials with selected patient groups as well as population-based register studies with suboptimal diagnostic reliability. The aim of the study was to describe incidence, etiology, and mortality of well......-validated cirrhotic cases in a population-based cohort at Funen (population 470,000) between 1996 and 2006....

  16. Changing incidence and improved survival of gliomas

    NARCIS (Netherlands)

    Ho, Vincent K. Y.; Reijneveld, Jaap C.; Enting, Roeline; Bienfait, Henri P.; Robe, Pierre; Baumert, Brigitta G.; Visser, Otto

    2014-01-01

    BACKGROUND: Tumours of the central nervous system (CNS) represent a relatively rare but serious health burden. This study provides insight into the incidence and survival patterns of gliomas in the Netherlands diagnosed in adult patients during the time period 1989-2010, with a focus on glioblastoma

  17. Low-Incidence, High-Consequence Pathogens

    Centers for Disease Control (CDC) Podcasts

    2014-02-21

    Dr. Stephan Monroe, a deputy director at CDC, discusses the impact of low-incidence, high-consequence pathogens globally.  Created: 2/21/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/26/2014.

  18. National Toxic Substance Incidents Program (NTSIP)

    Centers for Disease Control (CDC) Podcasts

    2011-02-03

    This podcast gives an overview of the three components of the National Toxic Substance Incidents Program: state surveillance, national database, and response teams.  Created: 2/3/2011 by Agency for Toxic Substances and Disease Registry.   Date Released: 2/3/2011.

  19. Spatial-Temporal Dynamics of Urban Fire Incidents: a Case Study of Nanjing, China

    OpenAIRE

    Yao, J; Zhang, X

    2016-01-01

    Fire and rescue service is one of the fundamental public services provided by government in order to protect people, properties and\\ud environment from fires and other disasters, and thus promote a safer living environment. Well understanding spatial-temporal\\ud dynamics of fire incidents can offer insights for potential determinants of various fire events and enable better fire risk estimation,\\ud assisting future allocation of prevention resources and strategic planning of mitigation progra...

  20. SPATIAL-TEMPORAL DYNAMICS OF URBAN FIRE INCIDENTS: A CASE STUDY OF NANJING, CHINA

    OpenAIRE

    Yao, J; Zhang, X

    2016-01-01

    Fire and rescue service is one of the fundamental public services provided by government in order to protect people, properties and environment from fires and other disasters, and thus promote a safer living environment. Well understanding spatial-temporal dynamics of fire incidents can offer insights for potential determinants of various fire events and enable better fire risk estimation, assisting future allocation of prevention resources and strategic planning of mitigation programs. Using...

  1. Plan Representations for Distributed Planning and Execution

    Science.gov (United States)

    2011-08-01

    Representation Planning is commonly associated with intelligent behavior in agents [Russell and Norvig , 2003]. The activity of planning can be defined...formulation [Russell and Norvig , 2003], is essential for enabling efficient problem-solving though search [Amarel, 1968]. The Planning Domain Definition... Norvig , 2003]. Preprocessing of planning domains is a technique that has been used to speed up the planning pro- cess [Dawson and Siklossy, 1977]. Perhaps

  2. International measles incidence and immunization coverage.

    Science.gov (United States)

    Hall, Robert; Jolley, Damien

    2011-07-01

    Measles is exquisitely sensitive to immunization programs. We investigated the decline in measles incidence after immunization with 1 or 2 doses of measles-containing vaccine (MCV), with or without supplementary immunization activities (SIAs). Using data from the World Health Organization, we modeled the impact of measles immunization using a negative binomial regression model. All countries offer measles immunization, and 192 of 193 countries offer a second dose of MCV (MCV2), using either a routine second dose, SIAs, or both. The incidence of measles fell from a median of 70.9 cases/100,000/year when coverage with a first dose of MCV (MCV1) was in the range of 0%-39% to a median of .9 cases/100,000/year when MCV1 coverage was 90%-100%, in both cases with no MCV2. Further reductions followed the introduction of MCV2 and SIAs. Modeling showed that each 1% increase in MCV1 coverage was followed by a 2.0% decrease in incidence in the same and following years (95% confidence interval [CI], 2.0%-1.9%, and 2.1%-1.9%, respectively). For a second dose, a rise of 1% in MCV2 coverage was followed by a decrease in measles incidence by .4% (95% CI, .3%-.5%) in the same year and .3% (95% CI, .2%-.5%) in the following year. SIAs were followed by decreases of measles incidence by 40.3% (95% CI, 46.3%-33.8%) in the same year and 45.2% (95% CI, 51.1%-48.7%) in the following year. A herd immunity effect was demonstrated with MCV1 coverage of >80%, and SIAs are an extraordinarily effective strategy for measles control.

  3. Cancer incidence in Italian contaminated sites

    Directory of Open Access Journals (Sweden)

    Pietro Comba

    2014-06-01

    Full Text Available INTRODUCTION. The incidence of cancer among residents in sites contaminated by pollutants with a possible health impact is not adequately studied. In Italy, SENTIERI Project (Epidemiological study of residents in National Priority Contaminated Sites, NPCSs was implemented to study major health outcomes for residents in 44 NPCSs. METHODS. The Italian Association of Cancer Registries (AIRTUM records cancer incidence in 23 NPCSs. For each NPCSs, the incidence of all malignant cancers combined and 35 cancer sites (coded according to ICD-10, was analysed (1996-2005. The observed cases were compared to the expected based on age (5-year period,18 classes, gender, calendar period (1996-2000; 2001-2005, geographical area (North-Centre and Centre-South and cancer sites specific rates. Standardized Incidence Ratios (SIR with 90% Confidence Intervals were computed. RESULTS. In both genders an excess was observed for overall cancer incidence (9% in men and 7% in women as well as for specific cancer sites (colon and rectum, liver, gallbladder, pancreas, lung, skin melanoma, bladder and Non Hodgkin lymphoma. Deficits were observed for gastric cancer in both genders, chronic lymphoid leukemia (men, malignant thyroid neoplasms, corpus uteri and connective and soft-tissue tumours and sarcomas (women. DISCUSSION. This report is, to our knowledge, the first one on cancer risk of residents in NPCSs. The study, although not aiming to estimate the cancer burden attributable to the environment as compared to occupation or life-style, supports the credibility of an etiologic role of environmental exposures in contaminated sites. Ongoing analyses focus on the interpretation of risk factors for excesses of specific cancer types overall and in specific NPCSs in relation to the presence of carcinogenic pollutants.

  4. Cancer Incidence and Mortality in China, 2007

    Institute of Scientific and Technical Information of China (English)

    Wan-qing Chen; Hong-mei Zeng; Rong-shou Zheng; Si-wei Zhang; Jie He

    2012-01-01

    Objective:Cancer incidence and mortality data collected from population-based cancer registries were analyzed to present the overall cancer statistics in Chinese registration areas by age,sex and geographic area in 2007.Methods:In 2010,48 cancer registries reported cancer incidence and mortality data of 2007 to National Central Cancer Registry of China.Of them,38 registries' data met the national criteria.Incidence and mortality were calculated by cancer sites,age,gender,and area.Age-standardized rates were described by China and World population.Results:The crude incidence rate for all cancers was 276.16/100,000 (305.22/100,000 for male and 246.46/100,000 for female; 284.71/100,000 in urban and 251.07/100,000 in rural).Age-standardized incidence rates by China and World population were 145.39/100,000 and 189.46/100,000 respectively.The crude mortality rate for all cancers was 177.09/100,000 (219.15/100,000 for male and 134.10/100,000 for female; 173.55/100,000 in urban and 187.49/100,000 in rural).Age-standardized mortality rates by China and World population were 86.06/100,000 and 116.46/100,000,respectively.The top 10 most frequently common cancer sites were the lung,stomach,colon and rectum,liver,breast,esophagus,pancreas,bladder,brain and lymphoma,accounting for 76.12% of the total cancer cases.The top 10 causes of cancer death were cancers of the lung,liver,stomach,esophagus,colon and rectum,pancreas,breast,leukemia,brain and lymphoma,accounting for 84.37% of the total cancer deaths.Conclusion:Cancer remains a major disease threatening people's health in China.Prevention and control should be enhanced,especially for the main cancers.

  5. Prevention of a wrong-location misadministration through the use of an intradepartmental incident learning system

    Energy Technology Data Exchange (ETDEWEB)

    Ford, Eric C.; Smith, Koren; Harris, Kendra; Terezakis, Stephanie [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231 (United States)

    2012-11-15

    Purpose: A series of examples are presented in which potential errors in the delivery of radiation therapy were prevented through use of incident learning. These examples underscore the value of reporting near miss incidents. Methods: Using a departmental incident learning system, eight incidents were noted over a two-year period in which fields were treated 'out-of-sequence,' that is, fields from a boost phase were treated, while the patient was still in the initial phase of treatment. As a result, an error-prevention policy was instituted in which radiation treatment fields are 'hidden' within the oncology information system (OIS) when they are not in current use. In this way, fields are only available to be treated in the intended sequence and, importantly, old fields cannot be activated at the linear accelerator control console. Results: No out-of-sequence treatments have been reported in more than two years since the policy change. Furthermore, at least three near-miss incidents were detected and corrected as a result of the policy change. In the first two, the policy operated as intended to directly prevent an error in field scheduling. In the third near-miss, the policy operated 'off target' to prevent a type of error scenario that it was not directly intended to prevent. In this incident, an incorrect digitally reconstructed radiograph (DRR) was scheduled in the OIS for a patient receiving lung cancer treatment. The incorrect DRR had an isocenter which was misplaced by approximately two centimeters. The error was a result of a field from an old plan being scheduled instead of the intended new plan. As a result of the policy described above, the DRR field could not be activated for treatment however and the error was discovered and corrected. Other quality control barriers in place would have been unlikely to have detected this error. Conclusions: In these examples, a policy was adopted based on incident learning, which

  6. Hazard based models for freeway traffic incident duration.

    Science.gov (United States)

    Tavassoli Hojati, Ahmad; Ferreira, Luis; Washington, Simon; Charles, Phil

    2013-03-01

    Assessing and prioritising cost-effective strategies to mitigate the impacts of traffic incidents and accidents on non-recurrent congestion on major roads represents a significant challenge for road network managers. This research examines the influence of numerous factors associated with incidents of various types on their duration. It presents a comprehensive traffic incident data mining and analysis by developing an incident duration model based on twelve months of incident data obtained from the Australian freeway network. Parametric accelerated failure time (AFT) survival models of incident duration were developed, including log-logistic, lognormal, and Weibul-considering both fixed and random parameters, as well as a Weibull model with gamma heterogeneity. The Weibull AFT models with random parameters were appropriate for modelling incident duration arising from crashes and hazards. A Weibull model with gamma heterogeneity was most suitable for modelling incident duration of stationary vehicles. Significant variables affecting incident duration include characteristics of the incidents (severity, type, towing requirements, etc.), and location, time of day, and traffic characteristics of the incident. Moreover, the findings reveal no significant effects of infrastructure and weather on incident duration. A significant and unique contribution of this paper is that the durations of each type of incident are uniquely different and respond to different factors. The results of this study are useful for traffic incident management agencies to implement strategies to reduce incident duration, leading to reduced congestion, secondary incidents, and the associated human and economic losses.

  7. Additional renal arteries: incidence and morphometry.

    Science.gov (United States)

    Satyapal, K S; Haffejee, A A; Singh, B; Ramsaroop, L; Robbs, J V; Kalideen, J M

    2001-01-01

    Advances in surgical and uro-radiological techniques dictate a reappraisal and definition of renal arterial variations. This retrospective study aimed at establishing the incidence of additional renal arteries. Two subsets were analysed viz.: a) Clinical series--130 renal angiograms performed on renal transplant donors, 32 cadaver kidneys used in renal transplantation b) Cadaveric series--74 en-bloc morphologically normal kidney pairs. The sex and race distribution was: males 140, females 96; African 84, Indian 91, White 43 and "Coloured" 18, respectively. Incidence of first and second additional arteries were respectively, 23.2% (R: 18.6%; L: 27.6%) and 4.5% (R: 4.7%; L: 4.4%). Additional arteries occurred more frequently on the left (L: 32.0%; R: 23.3%). The incidence bilaterally was 10.2% (first additional arteries, only). The sex and race incidence (first and second additional) was: males, 28.0%, 5.1%; females, 16.4%, 3.8% and African 31.1%, 5.4%; Indian 13.5%, 4.5%; White 30.9%, 4.4% and "Coloured" 18.5%, 0%; respectively. Significant differences in the incidence of first additional arteries were noted between sex and race. The morphometry of additional renal arteries were lengths (cm) of first and second additional renal arteries: 4.5 and 3.8 (right), 4.9 and 3.7 (left); diameters: 0.4 and 0.3 (right), 0.3 and 0.3 (left). Detailed morphometry of sex and race were also recorded. No statistically significant differences were noted. Our results of the incidence of additional renal arteries of 27.7% compared favourably to that reported in the literature (weighted mean 28.1%). The study is unique in recording detailed morphometry of these vessels. Careful techniques in the identification of this anatomical variation is important since it impacts on renal transplantation surgery, vascular operations for renal artery stenosis, reno-vascular hypertension, Takayasu's disease, renal trauma and uro-radiological procedures.

  8. An introductory characterization of a combat-casualty-care relevant swine model of closed head injury resulting from exposure to explosive blast.

    Science.gov (United States)

    Bauman, Richard A; Ling, Geoffrey; Tong, Lawrence; Januszkiewicz, Adolph; Agoston, Dennis; Delanerolle, Nihal; Kim, Young; Ritzel, Dave; Bell, Randy; Ecklund, James; Armonda, Rocco; Bandak, Faris; Parks, Steven

    2009-06-01

    Explosive blast has been extensively used as a tactical weapon in Operation Iraqi Freedom (OIF) and more recently in Operation Enduring Freedom(OEF). The polytraumatic nature of blast injuries is evidence of their effectiveness,and brain injury is a frequent and debilitating form of this trauma. In-theater clinical observations of brain-injured casualties have shown that edema, intracranial hemorrhage, and vasospasm are the most salient pathophysiological characteristics of blast injury to the brain. Unfortunately, little is known about exactly how an explosion produces these sequelae as well as others that are less well documented. Consequently, the principal objective of the current report is to present a swine model of explosive blast injury to the brain. This model was developed during Phase I of the DARPA (Defense Advanced Research Projects Agency) PREVENT (Preventing Violent Explosive Neurotrauma) blast research program. A second objective is to present data that illustrate the capabilities of this model to study the proximal biomechanical causes and the resulting pathophysiological, biochemical,neuropathological, and neurological consequences of explosive blast injury to the swine brain. In the concluding section of this article, the advantages and limitations of the model are considered, explosive and air-overpressure models are compared, and the physical properties of an explosion are identified that potentially contributed to the in-theater closed head injuries resulting from explosions of improvised explosive devices (IEDs).

  9. Analysis of the personnel casualty reasons and evacuating behavior in the fire%火灾中人员伤亡原因及疏散行为

    Institute of Scientific and Technical Information of China (English)

    庞建军

    2012-01-01

    根据火灾调查取得的有关参数,使用FDS火灾模拟软件对火灾过程进行了模拟,取得了楼梯间内一氧化碳、二氧化碳、氧气含量及能见度等模拟数据.燃烧产物毒害性、高温烟气、烟气减光性是火灾中致人伤亡的原因.针对火灾中人员的疏散行为,分析了火灾事故教训,提出了预防伤亡的措施.%The paper uses the software of Fire Dynamics Simulator to simulate the course of fire by the parameter from the investigation the fire. FDS calculates the concentration of COi CO2 > O2 and the visibility in the course of fire. It is the poison from the products of combustion. the smoke and gas with high temperature and the strong smoke that make people die and injured in the fire. It analyzes the lessons of the fire accidents, puts forward the prevention measures of personnel casualty in the fire by analyzing of evacuating behavior.

  10. A Study of Casualties of Vulnerable Groups in Fire Disasters%老弱病残火灾事故伤亡原因及消防对策

    Institute of Scientific and Technical Information of China (English)

    肖峰; 王福东

    2012-01-01

    通过对火灾起数、区域、季节、时间等方面进行比较,对老弱病残弱势群体在火灾事故中伤亡的原因进行了分析,研究了人员消防安全意识、消防安全管理、消防队伍建设等问题,提出有针对性的对老弱病残弱势群体的消防安全管理措施,为今后有效遏制弱势群体火灾多发势头提供一定的参考作用。%This paper analyzes the causes of casusualties of vulnerable groups in fire disasters in terms of the nember of fire disasters, locations and time, including fire safety awareness, fire safety management and fire forces. This pa- per offers some fire safety measures to check the increasing number of casualties of vulnerable in fire disastera.

  11. Incidence and predictors of readmission to the cardiac surgery intensive care unit: A retrospective cohort study in Greece

    Directory of Open Access Journals (Sweden)

    Konstantinos Giakoumidakis

    2014-01-01

    Conclusions: One intraoperative and three preoperative variables are associated strongly with higher probability for ICU readmission. Shorter CPB duration could contribute to lower ICU readmission incidence. In addition, the early identification of high risk patients for readmission in the cardiac surgery ICU could encourage both the more efficient healthcare planning and resources allocation.

  12. Los Alamos National Laboratory emergency management plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents, transportation accidents, electrical accidents, and natural disasters.

  13. Monte Carlo Treatment Planning for Advanced Radiotherapy

    DEFF Research Database (Denmark)

    Cronholm, Rickard

    and validation of a Monte Carlo model of a medical linear accelerator (i), converting a CT scan of a patient to a Monte Carlo compliant phantom (ii) and translating the treatment plan parameters (including beam energy, angles of incidence, collimator settings etc) to a Monte Carlo input file (iii). A protocol...... previous algorithms since it uses delineations of structures in order to include and/or exclude certain media in various anatomical regions. This method has the potential to reduce anatomically irrelevant media assignment. In house MATLAB scripts translating the treatment plan parameters to Monte Carlo...

  14. Incidence of anemia in patients diagnosed with solid tumors receiving chemotherapy, 2010–2013

    Science.gov (United States)

    Xu, Hairong; Xu, Lanfang; Page, John H; Cannavale, Kim; Sattayapiwat, Olivia; Rodriguez, Roberto; Chao, Chun

    2016-01-01

    Purpose The purpose of this study was to evaluate and characterize the risk of anemia during the course of chemotherapy among patients with five common types of solid tumors. Patients and methods Patients diagnosed with incident cancers of breast, lung, colon/rectum, stomach, and ovary who received chemotherapy were identified from Kaiser Permanente Southern California Health Plan (2010–2012). All clinical data were collected from the health plan’s electronic medical records. Incidence proportions of patients developing anemia and 95% confidence intervals were calculated overall and by anemia severity and type, as well as by stage at cancer diagnosis, and by chemotherapy regimen and cycle. Results A total of 4,426 patients who received chemotherapy were included. Across cancers, 3,962 (89.5%) patients developed anemia during the course of chemotherapy (normocytic 85%, macrocytic 10%, microcytic 5%; normochromic 47%, hyperchromic 44%, hypochromic 9%). The anemia grades were distributed as follows: 58% were grade 1, 34% grade 2, 8% grade 3, and anemia ranged from 26.3% in colorectal cancer patients to 59.2% in ovarian cancer patients. Incidence of grade 2+ anemia increased from 29% in stage I to 49% in stage IV. Incidence of grade 2+ anemia varied from 18.2% in breast cancer patients treated with cyclophosphamide + docetaxel regimen to 59.7% in patients with ovarian cancer receiving carboplatin + paclitaxel regimen. Conclusion The incidence of moderate-to-severe anemia (hemoglobin anemia was greater in patients with distant metastasis. PMID:27186078

  15. The incidence of pelvic inflammatory disease in untreated women infected with Chlamydia trachomatis: a structured review.

    Science.gov (United States)

    Risser, W L; Risser, J M H

    2007-11-01

    Because of the long-term consequences of pelvic inflammatory disease (PID), the cost-effectiveness of Chlamydia trachomatis screening depends in part on the incidence of PID in untreated, chlamydia-infected women. The aim of this study was to evaluate the original research assessing the incidence of PID following C. trachomatis infection. We conducted a thorough search of the literature and selected all available prospective cohort studies. Six studies had original data: the incidence of PID varied from 0% (97.5% confidence interval [CI] 0-12%) during one year of follow-up of 30 women to 30% (95% CI 12-54%) during 50 days of follow-up of 20 women. Studies that included asymptomatic women in other settings reported a lower incidence than those that evaluated women in sexually transmitted disease clinics. In conclusion, no study was of a size or quality to answer our research question definitively. Investigators and clinicians planning chlamydia-screening programmes need to be cognizant of the inconclusive incidence data.

  16. Hanford Site Development Plan

    Energy Technology Data Exchange (ETDEWEB)

    Rinne, C.A.; Curry, R.H.; Hagan, J.W.; Seiler, S.W.; Sommer, D.J. (Westinghouse Hanford Co., Richland, WA (USA)); Yancey, E.F. (Pacific Northwest Lab., Richland, WA (USA))

    1990-01-01

    The Hanford Site Development Plan (Site Development Plan) is intended to guide the short- and long-range development and use of the Hanford Site. All acquisition, development, and permanent facility use at the Hanford Site will conform to the approved plan. The Site Development Plan also serves as the base document for all subsequent studies that involve use of facilities at the Site. This revision is an update of a previous plan. The executive summary presents the highlights of the five major topics covered in the Site Development Plan: general site information, existing conditions, planning analysis, Master Plan, and Five-Year Plan. 56 refs., 67 figs., 31 tabs.

  17. SEXUALLY TRANSMITTED DISEASES: INCIDENCE AND DISTRIBUTION

    Institute of Scientific and Technical Information of China (English)

    王千秋

    1996-01-01

    The incidence of sexually transmitted diseases(STDs) increased from 26. 04 per 10000O in 1987 to 104. 81 per 100 000 in 1993 in selected areas of the country. Gonorrhea is by far the most common STD but its constituent ratio declined because of a rapid increase of nongonococcal uretheritis and genital warts during most recent years. The incidence of syphilis is relatively low and cases of congenital infection are noted. The wide spread of resistant Neisseria gonorrhaeae infection gives a challenge to the therapeutical and control strategies of STDs. Sexually transmitted Chlamydia trachomatis infections, an important cause of urethritis, cervicitis and pelvic inflammatory disease, is becoming common in uur country. Attention has been drawn on viral hepatitis in their means of transmission by sexually behaviors, and also, on the homosexuals, assumed to be the high risk group to catch STDs. Coordinated national efforts to control STDs in China have been taken.

  18. Stressful life events and incident metabolic syndrome

    DEFF Research Database (Denmark)

    Rutters, Femke; Pilz, Stefan; Koopman, Anitra D M

    2015-01-01

    Stressful life events are associated with the metabolic syndrome in cross-sectional studies, but prospective studies addressing this issue are rare and limited. We therefore evaluated whether the number of stressful life events is associated with incident metabolic syndrome. We assessed...... the association between the number of stressful life events experienced in the 5 years up until baseline and incident metabolic syndrome after 6.5 years at follow-up in the Hoorn study, a middle-aged and elderly population-based cohort. Participants with prevalent metabolic syndrome at baseline were excluded....... Metabolic syndrome was defined according to the Adult Treatment Panel III, including fasting plasma glucose levels, HDL-C levels, triglyceride levels, waist circumference and hypertension. We included 1099 participants (47% male; age 60 ± 7 years). During 6.5 years of follow-up, 238 participants (22...

  19. Bacillus anthracis Bioterrorism Incident, Kameido, Tokyo, 1993

    Science.gov (United States)

    Keim, Paul; Kaufmann, Arnold F.; Keys, Christine; Smith, Kimothy L.; Taniguchi, Kiyosu; Inouye, Sakae; Kurata, Takeshi

    2004-01-01

    In July 1993, a liquid suspension of Bacillus anthracis was aerosolized from the roof of an eight-story building in Kameido, Tokyo, Japan, by the religious group Aum Shinrikyo. During 1999 to 2001, microbiologic tests were conducted on a liquid environmental sample originally collected during the 1993 incident. Nonencapsulated isolates of B. anthracis were cultured from the liquid. Multiple-locus, variable-number tandem repeat analysis found all isolates to be identical to a strain used in Japan to vaccinate animals against anthrax, which was consistent with the Aum Shinrikyo members’ testimony about the strain source. In 1999, a retrospective case-detection survey was conducted to identify potential human anthrax cases associated with the incident, but none were found. The use of an attenuated B. anthracis strain, low spore concentrations, ineffective dispersal, a clogged spray device, and inactivation of the spores by sunlight are all likely contributing factors to the lack of human cases. PMID:15112666

  20. The Nanjing Incident: Recent Research and Trends

    Directory of Open Access Journals (Sweden)

    ASKEW, David

    2002-04-01

    Full Text Available The Nanjing Incident remains a highly controversial episode in Sino-Japanese relations. It remains so controversial that a neutral definition has yet to be agreed upon. However, most would perhaps agree on the following. Sadly for the historian, however, the Nanjing Incident is also emerging as a fundamental keystone in the construction of the modern Chinese national identity. As a result, the historian's interest in and analysis of this event can be interpreted as an attack on the contemporary Chinese identity, while any demonstrated interest in Nanjing can be viewed in some circles in Japan as Japan bashing or self-flagellation. In this environment, the historian's struggle to maintain objectivity can quickly fall victim to the demands of contemporary politics.

  1. Inaccurate reporting of simulated critical anaesthetic incidents.

    Science.gov (United States)

    Byrne, A J; Jones, J G

    1997-06-01

    Eleven anaesthetists completed a simulated anaesthetic which was deliberately complicated by a slow progressive bradycardia followed by an episode of severe bronchospasm. After the simulation, each anaesthetist was asked to complete an anaesthetic chart and a critical incident report. Considerable discrepancies were found between the anaesthetists' written accounts, a videotape of their performance and actual data from the simulator. During the simulations, all of the anaesthetists reacted appropriately and treated their "patient" successfully but their written accounts showed a tendency to record "typical" rather than actual events and to ignore events not consistent with their final diagnosis. Only four anaesthetists mentioned bradycardia in their written description and none accurately described the changes in arterial pressure during the episode of bronchospasm. The findings are in keeping with other studies which suggest that people record events as "schemata" rather than as collections of discrete facts. These results have significant implications for those involved in the teaching of anaesthesia and in the analysis of critical incidents.

  2. Incidence of Phenylketonuria in Southern Iran

    Directory of Open Access Journals (Sweden)

    Asadollah Habib

    2010-06-01

    Full Text Available AbstractBackground: Phenylketonuria is a hereditary, autosomal recessivedisorder caused by deficiency of phenylalanine hydroxylaseor its cofactor tetrahydrobiopterin. The purpose ofthe present study was to evaluate the incidence of this disorderin southern Iran.Methods: All the neonates born between 22/Dec/2004 and7/Sep/2007 were screened and their blood samples were testedby colorimetric and high performance liquid chromatographymethods to obtain a diagnosis of phenylketonuria.Results: Of the screened newborns (87091 females and 88143males 15 female and 13 male neonates were diagnosed definitelyas having phenylketonuria.Conclusion: The incidence of phenylketonuria in girls andboys was 1.7 in 10000 and 1.5 in 10000, respectively (mean:1.6 in 10000 in southern Iran (Fars province.Iran J Med Sci 2010; 35(2: 137-139.

  3. Cancer incidence in blood transfusion recipients

    DEFF Research Database (Denmark)

    Hjalgrim, Henrik; Edgren, Gustaf; Rostgaard, Klaus

    2007-01-01

    BACKGROUND: Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. METHODS: We used computerized files from Scandinavian...... blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios...... of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred...

  4. Injury incidence and cause in elite gymnasts.

    Science.gov (United States)

    Felländer-Tsai, L; Wredmark, T

    1995-01-01

    This report describes the incidence, localization, and cause of injuries in Swedish male and female elite gymnasts during 18 active months (three seasons). Thirty-one elite gymnast clubs with all together 437 gymnasts were included in the study, which consisted of a written questionnaire reporting morphometric facts as well as data concerning the injury. There were in total 82 injury reports. The injury incidence was 6.25 per 100 elite gymnasts and season. A majority of the injuries occurred in the lower extremities. The right leg was injured more often than the left. Most of the severe injuries occurred during mounting and dismounting which advocates the need for preventive measures in association with these particular events. Male gymnasts were more prone to sustain severer injuries such as dislocations and fractures. Severe injuries affected the upper extremity in 83%, and the right side was injured more often than the left.

  5. Incidence of dental caries in chronic urticaria

    Directory of Open Access Journals (Sweden)

    Kaur Surrinder

    1991-01-01

    Full Text Available Three hundred patients of chronic urticaria were screened for dental affections. Sixty two (20.66% patients were detected to have dental caries. Among the control group which com-prised of 100 patients, 20% had dental caries. There was thus no increased incidence of dental caries among patients with urticaria. Only 2 patients had remission of urticaria following treat-ment of caries. Dental caries therefore is probably not a cause of chronic urticaria.

  6. Incidence and recognition of malnutrition in hospital.

    OpenAIRE

    1994-01-01

    OBJECTIVES--To determine incidence of malnutrition among patients on admission to hospital, to monitor their changes in nutritional status during stay, and to determine awareness of nutrition in different clinical units. DESIGN--Prospective study of consecutive admissions. SETTING--Acute teaching hospital. SUBJECTS--500 patients admitted to hospital: 100 each from general surgery, general medicine, respiratory medicine, orthopaedic surgery, and medicine for the elderly. MAIN OUTCOME MEASURES-...

  7. Electrically floating, near vertical incidence, skywave antenna

    Science.gov (United States)

    Anderson, Allen A.; Kaser, Timothy G.; Tremblay, Paul A.; Mays, Belva L.

    2014-07-08

    An Electrically Floating, Near Vertical Incidence, Skywave (NVIS) Antenna comprising an antenna element, a floating ground element, and a grounding element. At least part of said floating ground element is positioned between said antenna element and said grounding element. The antenna is separated from the floating ground element and the grounding element by one or more electrical insulators. The floating ground element is separated from said antenna and said grounding element by one or more electrical insulators.

  8. Increasing incidence of coeliac disease in Sweden.

    Science.gov (United States)

    Ascher, H; Krantz, I; Kristiansson, B

    1991-01-01

    Changes in the incidence of coelic disease was studied among children born in Göteborg, Sweden, between 1970 and 1988. A total of 188 patients with coeliac disease were found. Of these, 83% were less than 2 years old at the time of their first duodenal biopsy and 74% of them have so far been verified according to the criteria of the European Society for Gastroenterology and Nutrition (ESPGAN). The cumulative incidence at 2 years of age/1000 liveborn infants increased significantly from 0.31 in the first birth cohort to 2.93 in the last. This increase could only partly be explained by improvements in detection. Weight for age at diagnosis was generally considerably below the reference value, but was slightly less affected towards the end of the period. The increase in incidence of coeliac disease is the first reported since the middle 1970s and makes the disease one of the most common chronic diseases among Swedish children. PMID:2039251

  9. Risk Insights Gained from Fire Incidents

    Energy Technology Data Exchange (ETDEWEB)

    Kazarians, Mardy; Nowlen, Steven P.

    1999-06-10

    There now exist close to 20 years of history in the application of Probabilistic Risk Assessment (PRA) for the analysis of fire risk at nuclear power plants. The current methods are based on various assumptions regarding fire phenomena, the impact of fire on equipment and operator response, and the overall progression of a fire event from initiation through final resolution. Over this same time period, a number of significant fire incidents have occurred at nuclear power plants around the world. Insights gained from US experience have been used in US studies as the statistical basis for establishing fire initiation frequencies both as a function of the plant area and the initiating fire source.To a lesser extent, the fire experience has also been used to assess the general severity and duration of fires. However, aside from these statistical analyses, the incidents have rarely been scrutinized in detail to verify the underlying assumptions of fire PRAs. This paper discusses an effort, under which a set of fire incidents are being reviewed in order to gain insights directly relevant to the methods, data, and assumptions that form the basis for current fire PRAs. The paper focuses on the objectives of the effort, the specific fire events being reviews methodology, and anticipated follow-on activities.

  10. Increasing Incidence of Canine Leptospirosis in Switzerland

    Directory of Open Access Journals (Sweden)

    Andrea Major

    2014-07-01

    Full Text Available A marked increase in canine leptospirosis was observed in Switzerland over 10 years with a peak incidence of 28.1 diagnosed cases/100,000 dogs/year in the most affected canton. With 95% affected dogs living at altitudes <800 m, the disease presented a seasonal pattern associated with temperature (r2 0.73 and rainfall (r2 0.39, >90% cases being diagnosed between May and October. The increasing yearly incidence however was only weakly correlated with climatic data including number of summer (r2 0.25 or rainy days (r2 0.38. Serovars Australis and Bratislava showed the highest seropositivity rates with 70.5% and 69.1%, respectively. Main clinical manifestations included renal (99.6%, pulmonary (76.7%, hepatic (26.0%, and hemorrhagic syndromes (18.2%, leading to a high mortality rate (43.3%. Similar to the human disease, liver involvement had the strongest association with negative outcome (OR 16.3. Based on these data, canine leptospirosis presents similar features and severity as the human infection for which it therefore can be considered a model. Its re-emergence in a temperate country with very high incidence rates in canines should thus be viewed as a warning and emphasize the need for increased awareness in other species.

  11. Grazing incidence absorption measurements. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1989-07-31

    This final report summarizes the results of a series of different measurements to characterize various mirrors of interest to Los Alamos National Laboratory and the Boeing Aerospace free electron laser program. Most of the measurements were of the glancing incidence characteristics of different overcoated silver mirrors. These included the absolute absorptance as a function of angle of incidence (0--88{degrees}), laser wavelength (0.5145 and 1.06 {mu}m), polarization, and exposure to room air. The latter measurement examined the ability of the overcoated silver mirrors to resist tarnishing. Overcoating materials used were single-layer ThF{sub 4} and MgF{sub 2}, a very thin layer of Al{sub 2}O{sub 3}, and diamond. As a result of the work performed during this program, significant progress has been made to find a better alternative to bare silver mirrors for high-power laser applications. Thick dielectric overcoats do protect the silver mirrors from tarnishing, but problems associated with accurately controlling the optical constants of the dielectric during the coating process appear to make it difficult to achieve the desired optical properties of the mirrors at high angles of incidence.

  12. A common language for computer security incidents

    Energy Technology Data Exchange (ETDEWEB)

    John D. Howard; Thomas A Longstaff

    1998-10-01

    Much of the computer security information regularly gathered and disseminated by individuals and organizations cannot currently be combined or compared because a common language has yet to emerge in the field of computer security. A common language consists of terms and taxonomies (principles of classification) which enable the gathering, exchange and comparison of information. This paper presents the results of a project to develop such a common language for computer security incidents. This project results from cooperation between the Security and Networking Research Group at the Sandia National Laboratories, Livermore, CA, and the CERT{reg_sign} Coordination Center at Carnegie Mellon University, Pittsburgh, PA. This Common Language Project was not an effort to develop a comprehensive dictionary of terms used in the field of computer security. Instead, the authors developed a minimum set of high-level terms, along with a structure indicating their relationship (a taxonomy), which can be used to classify and understand computer security incident information. They hope these high-level terms and their structure will gain wide acceptance, be useful, and most importantly, enable the exchange and comparison of computer security incident information. They anticipate, however, that individuals and organizations will continue to use their own terms, which may be more specific both in meaning and use. They designed the common language to enable these lower-level terms to be classified within the common language structure.

  13. Emergency and crisis management: critical incident stress management for first responders and business organisations.

    Science.gov (United States)

    Guenthner, Daniel H

    2012-01-01

    A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.

  14. Transportation Emergency Preparedness Program Plan, U.S. Department of Energy Region 6

    Energy Technology Data Exchange (ETDEWEB)

    Marsha Keister

    2010-04-01

    The United States Department of Energy (DOE) Region 6 Transportation Emergency Preparedness Program Plan (TEPP Plan) operates within the framework of the DOE emergency management system for developing, coordinating, and directing emergency planning, preparedness, and readiness assurance activities for radiological transportation incidents. The DOE Region 6 TEPP Plan is a narrative description of the DOE Transportation Emergency Preparedness Program activities, training and technical assistance provided to states and tribes along DOE's transportation corridors in DOE Region 6.

  15. MO-G-BRE-09: Validating FMEA Against Incident Learning Data: A Study in Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, F; Cao, N; Young, L; Howard, J; Sponseller, P; Logan, W; Arbuckle, T; Korssjoen, T; Meyer, J; Ford, E [Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States)

    2014-06-15

    Purpose: Though FMEA (Failure Mode and Effects Analysis) is becoming more widely adopted for risk assessment in radiation therapy, to our knowledge it has never been validated against actual incident learning data. The objective of this study was to perform an FMEA analysis of an SBRT (Stereotactic Body Radiation Therapy) treatment planning process and validate this against data recorded within an incident learning system. Methods: FMEA on the SBRT treatment planning process was carried out by a multidisciplinary group including radiation oncologists, medical physicists, and dosimetrists. Potential failure modes were identified through a systematic review of the workflow process. Failure modes were rated for severity, occurrence, and detectability on a scale of 1 to 10 and RPN (Risk Priority Number) was computed. Failure modes were then compared with historical reports identified as relevant to SBRT planning within a departmental incident learning system that had been active for two years. Differences were identified. Results: FMEA identified 63 failure modes. RPN values for the top 25% of failure modes ranged from 60 to 336. Analysis of the incident learning database identified 33 reported near-miss events related to SBRT planning. FMEA failed to anticipate 13 of these events, among which 3 were registered with severity ratings of severe or critical in the incident learning system. Combining both methods yielded a total of 76 failure modes, and when scored for RPN the 13 events missed by FMEA ranked within the middle half of all failure modes. Conclusion: FMEA, though valuable, is subject to certain limitations, among them the limited ability to anticipate all potential errors for a given process. This FMEA exercise failed to identify a significant number of possible errors (17%). Integration of FMEA with retrospective incident data may be able to render an improved overview of risks within a process.

  16. Cancer incidence in Thailand, 1995-1997.

    Science.gov (United States)

    Sriplung, Hutcha; Sontipong, Sineenat; Martin, Nimit; Wiangnon, Surapon; Vootiprux, Visoot; Cheirsilpa, Arkom; Kanchanabat, Chol; Khuhaprema, Theeravud

    2005-01-01

    There are five population-based cancer registries in Thailand in different regions of the country. Four of them (Chiang Mai, Khon Kaen, Bangkok, and Songkhla) have been operating since 1988 and the other (Lampang) since the early 1990s. These registries have published regular 3-year cancer incidence reports since the first in 1993 for the period 1989-1991. The objective of this article is to summarize the figures of cancer incidence in Thailand during 1995-1997. The population of Thailand in 1996, at the middle of the period, was 27 million males and 27.5 million females. Information of cancer cases residing in the five provinces was collected and abstracted from different sources. Age-standardized incidence rate (ASR) of cancer in males and females was calculated for each registry and that for the whole country was estimated using the five registries as representatives for the four geographical regions of Thailand. The estimated number of new cancer cases in 1996 for the whole country was 35,539 men and 38,476 women and the ASRs were 149.2 and 125.0 per 10(5) population in men and women respectively. Cancer incidences greatly differed from region to region. Lung cancer was the commonest in Chiang Mai and Lampang in the Northern region in both sexes. The incidence of liver cancer in Khon Kaen in the Northeastern region outnumbered all the others in both sexes; cholangiocarcinoma was the major type of liver cancer. In Bangkok, lung cancer was the most important cancer in males and breast cancer was in females. Though it was lung and cervix uteri cancer that ranked the first in men and women in Songkhla, the rate of oral and pharyngeal cancer was exceptionally higher than in other registries. The geographical variability in cancer patterns in Thailand reflects exposure of the population to different risk factors unique to the different regions. In the study as a whole, there are some methodological weak points in estimating the ASRs and number of cancer cases for the

  17. Plan Colombia

    Directory of Open Access Journals (Sweden)

    Noam Chomsky

    2000-12-01

    Full Text Available Colombia recibe más ayuda militar de Estados Unidos que el resto de América Latina y el Caribe unidos, y esta situación puede profundizarse con la ejecución del Plan Colombia, fundamentado en la lucha antidrogas. Sin embargo, el pais ha sido calificado con el récord en violación de derechos humanos. En este contexto se aplica la reforma económica más significativa en la década de los noventa, generando condicionantes en los procesos de integración con sus vecinos. En concordancia con el secretario de Defensa, Henry Stimson, desde los años 60 Estados Unidos estaba autorizado para controlar su propio sistema regional, mientras todos los demás intenlos serian desmantelados. La presentación ambigua de esta política del gobierno estadounidense en Colombia es cómo disociar esta guerra contra la droga y la lucha irregular contrainsurgente En Estados Unidos hay otra opinión que debe conocerse para comprender las divergencias en e! interior de dicho país. Este artículo del prestigioso profesor universitario del MU, Noam Chomsky, es un referente obligado en términos de opinión pública y académica de dimensión internacional, por el inmenso respeto que infunde tanto en América como en Europa

  18. TU-CD-BRD-00: Incident Learning / RO-ILS

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    It has long been standard practice in radiation oncology to report internally when a patient’s treatment has not gone as planned and to report events to regulatory agencies when legally required. Most potential errors are caught early and never affect the patient. Quality assurance steps routinely prevent errors from reaching the patient, and these “near misses” are much more frequent than treatment errors. A growing number of radiation oncology facilities have implemented incident learning systems to report and analyze both errors and near misses. Using the term “incident learning” instead of “event reporting” emphasizes the need to use these experiences to change the practice and make future errors less likely and promote an educational, non-punitive environment. There are challenges in making such a system practical and effective. Speakers from institutions of different sizes and practice environments will share their experiences on how to make such a system work and what benefits their clinics have accrued. Questions that will be addressed include: How to create a system that is easy for front line staff to access How to motivate staff to report How to promote the system as positive and educational and not punitive or demeaning How to organize the team for reviewing and responding to reports How to prioritize which reports to discuss in depth How not to dismiss the rest How to identify underlying causes How to design corrective actions and implement change How to develop useful statistics and analysis tools How to coordinate a departmental system with a larger risk management system How to do this without a dedicated quality manager Some speakers’ experience is with in-house systems and some will share experience with the AAPM/ASTRO national Radiation Oncology Incident Learning System (RO-ILS). Reports intended to be of value nationally need to be comprehensible to outsiders; examples of useful reports will be shown. There will be ample time set

  19. Maintenance Business Plans.

    Science.gov (United States)

    Adams, Matt

    2002-01-01

    Discusses maintenance business plans, statements which provide accountability for facilities maintenance organizations' considerable budgets. Discusses the plan's components: statement of plan objectives, macro and detailed description of the facility assets, maintenance function descriptions, description of key performance indicators, milestone…

  20. DASH Eating Plan

    Science.gov (United States)

    ... NHLBI on Twitter. Description of the DASH Eating Plan DASH is a flexible and balanced eating plan that helps create a heart-healthy eating style for life. The DASH eating plan requires no special foods and instead provides daily ...

  1. Calfornia General Plans Rural

    Data.gov (United States)

    California Department of Resources — We undertook creating the first ever seamless statewide General Plan map for California. All county general plans and many city general plans were integrated into 1...

  2. Plan by Increments

    Science.gov (United States)

    Kingsbury, M. E.

    1972-01-01

    The think big; paint an elephant" philosophy of planning is appealing in theory but appalling in practice. Too often, making no small plans results in making no plans at all. (11 references) (Author/NH)

  3. Calfornia General Plans

    Data.gov (United States)

    California Department of Resources — We undertook creating the first ever seamless statewide General Plan map for California. All county general plans and many city general plans were integrated into 1...

  4. Multi-Agent Planning with Planning Graph

    NARCIS (Netherlands)

    Bui, The Duy; Jamroga, Wojciech

    2003-01-01

    In this paper, we consider planning for multi-agents situations in STRIPS-like domains with planning graph. Three possible relationships between agents' goals are considered in order to evaluate plans: the agents may be collaborative, adversarial or indifferent entities. We propose algorithms to dea

  5. Key Response Planning Factors for the Aftermath of Nuclear Terrorism

    Energy Technology Data Exchange (ETDEWEB)

    Buddemeier, B R; Dillon, M B

    2009-01-21

    Despite hundreds of above-ground nuclear tests and data gathered from Hiroshima and Nagasaki, the effects of a ground-level, low-yield nuclear detonation in a modern urban environment are still the subject of considerable scientific debate. Extensive review of nuclear weapon effects studies and discussions with nuclear weapon effects experts from various federal agencies, national laboratories, and technical organizations have identified key issues and bounded some of the unknowns required to support response planning for a low-yield, ground-level nuclear detonation in a modern U.S. city. This study, which is focused primarily upon the hazards posed by radioactive fallout, used detailed fallout predictions from the advanced suite of three-dimensional (3-D) meteorology and plume/fallout models developed at Lawrence Livermore National Laboratory (LLNL), including extensive global Key Response Planning Factors for the Aftermath of Nuclear Terrorism geographical and real-time meteorological databases to support model calculations. This 3-D modeling system provides detailed simulations that account for complex meteorology and terrain effects. The results of initial modeling and analysis were presented to federal, state, and local working groups to obtain critical, broad-based review and feedback on strategy and messaging. This effort involved a diverse set of communities, including New York City, National Capitol Regions, Charlotte, Houston, Portland, and Los Angeles. The largest potential for reducing casualties during the post-detonation response phase comes from reducing exposure to fallout radiation. This can be accomplished through early, adequate sheltering followed by informed, delayed evacuation.B The response challenges to a nuclear detonation must be solved through multiple approaches of public education, planning, and rapid response actions. Because the successful response will require extensive coordination of a large number of organizations, supplemented by

  6. 11. Strategic planning.

    Science.gov (United States)

    2014-05-01

    There are several types of planning processes and plans, including strategic, operational, tactical, and contingency. For this document, operational planning includes tactical planning. This chapter examines the strategic planning process and includes an introduction into disaster response plans. "A strategic plan is an outline of steps designed with the goals of the entire organisation as a whole in mind, rather than with the goals of specific divisions or departments". Strategic planning includes all measures taken to provide a broad picture of what must be achieved and in which order, including how to organise a system capable of achieving the overall goals. Strategic planning often is done pre-event, based on previous experience and expertise. The strategic planning for disasters converts needs into a strategic plan of action. Strategic plans detail the goals that must be achieved. The process of converting needs into plans has been deconstructed into its components and includes consideration of: (1) disaster response plans; (2) interventions underway or planned; (3) available resources; (4) current status vs. pre-event status; (5) history and experience of the planners; and (6) access to the affected population. These factors are tempered by the local: (a) geography; (b) climate; (c) culture; (d) safety; and (e) practicality. The planning process consumes resources (costs). All plans must be adapted to the actual conditions--things never happen exactly as planned.

  7. Atchafalaya Alligator Harvest Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — 1988 Alligator Harvest Plan for Atchafalaya National Wildlife Refuge including management plan, environmental assessment, and public notice documents.

  8. Application of passive defense in urban housing planning

    Directory of Open Access Journals (Sweden)

    H. Kamran

    2013-01-01

    Full Text Available Extended abstract1-IntroductionToday, with advances in the technology of weapons and military equipment, urban areas are most at risk of invasion. Among the most important factors in enhancing human casualties in military attacks on urban areas, one can point to the unrealistic architecture of houses which does not conform to principles such as optimal site selection and layout of the structure of human settlements, proper distribution, principles of concealment, camouflage and deception, the high degree of vulnerability of buildings and interior architecture of buildings with regard to passive defense. Structural arrangement of spaces and their connection with surrounding areas has created great opportunities for saving lives And improves system performance and reduces its vulnerability. This study with a descriptive-qualitative approach, investigates the role of passive defense in urban housing planning and the conclusions are used to create safe city, strong city and deterrent city. Results show that determining the geometric design of house, pop location, availability and predictability of secure spaces are regarded as multi-functional space for each building in times of peace and war are among the optimal components of building architecture and vernacular architecture from the perspective of a passive defense.Crises, threats and disasters are classified into two main categories: natural, including earthquakes, floods, landslides, droughts and human category such as war, accidents and diseases which are more than 50 types. The main objective of this study is investigating crisis caused by war in residential areas. In the full-scale military conflicts, one of the ultimate goals of the parties involved is making an effort to bring the breadth and scope of the battlefield to civilian centers especially to urban centers, which is usually accompanied by heavy air strikes. This act is one of the most effective strategies in the fate of wars

  9. Incidence of pyometra in Swedish insured cats.

    Science.gov (United States)

    Hagman, Ragnvi; Ström Holst, Bodil; Möller, Lotta; Egenvall, Agneta

    2014-07-01

    Pyometra is a clinically relevant problem in intact female cats and dogs. The etiology is similar in both animal species, with the disease caused by bacterial infection of a progesterone-sensitized uterus. Here, we studied pyometra in cats with the aim to describe the incidence and probability of developing pyometra based on age and breed. The data used were reimbursed claims for veterinary care insurance or life insurance claims or both in cats insured in a Swedish insurance database from 1999 to 2006. The mean incidence rate (IR) for pyometra was about 17 cats per 10,000 cat years at risk (CYAR). Cats with pyometra were diagnosed at a median age of 4 years and a significant breed effect was observed. The breed with the highest IR (433 cats per 10,000 CYAR) was the Sphynx, and other breeds with IR over 60 cats per 10,000 CYAR were Siberian cat, Ocicat, Korat, Siamese, Ragdoll, Maine coon, and Bengal. Pyometra was more commonly diagnosed with increasing age, with a marked increase in cats older than 7 years. The mean case fatality rate in all cats was 5.7%, which is slightly higher than corresponding reports in dogs of 3% to 4%. Geographical location (urban or rural) did not affect the risk of developing the disease. The present study provides information of incidence and probability of developing pyometra based on age, breed, and urban or rural geographical location. These data may be useful for designing cat breeding programs in high-risk breeds and for future studies of the genetic background of the disease.

  10. Pelvic Incidence in Patients with Hip Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Ibrahim Raphael

    2016-04-01

    Full Text Available Background: Hip osteoarthritis (OA is a major cause of pain and disability that results in considerable social and medical costs. Mechanics such as posture, alignment and orientation of the hips and the spinal column and the relationship between these factors have been implicated in the development of both hip and spine pathologies. This study aims to test the hypothesis if pelvic incidence varies in patients with and without osteoarthritis. We assessed the relationship between spinopelvic alignment as measured by pelvic incidence (PI and the presence of hip OA. Methods: We collected supine pelvis CT scans of 1,012 consecutive patients not known to have hip OA. Our first group consisted of 95 patients with moderate to severe hip OA as per radiology reports. The second group included 87 patients with no evidence of hip OA. Power analysis revealed the need for 77 patients per group to find a mean difference in PI of 5º or less between both groups. Two trained physicians independently measured the PI to account for inter-observer reliability. Results: Patients with moderate to severe hip OA had a mean PI of 56.5º±12.8º. The mean PI for patients without hip OA was 57.2º±7.5º. An independent samples t-test revealed no significant difference between the PI values of the two groups. Spearman’s correlation coefficient of 0.754 demonstrated a high inter-observer reliability. Conclusion: There was no difference in PI angle of hip OA patients and "healthy" patients. Our measurements of patients without OA were almost identical to the reported normal PI values in the literature. It appears that hip OA is not associated with PI angle, refuting the hypothesis made in previous studies, stating that elevated PI contributes to the future development of hip arthritis. CT scan seems to be a reliable and accurate way of assessing pelvic incidence.

  11. Non-melanoma skin cancer incidence and impact of skin cancer screening on incidence.

    Science.gov (United States)

    Eisemann, Nora; Waldmann, Annika; Geller, Alan C; Weinstock, Martin A; Volkmer, Beate; Greinert, Ruediger; Breitbart, Eckhard W; Katalinic, Alexander

    2014-01-01

    Non-melanoma skin cancer (NMSC) is the most common malignancy, whose public health significance is often unrecognized. This analysis has two objectives: first, to provide up-to-date incidence estimates by sex, age group, histological type, and body site; and second, to study the impact of skin cancer screening. The impact of screening on NMSC incidence in Schleswig-Holstein, Germany, is analyzed by comparing four time periods of different screening settings (no screening (1998-2000), pilot project (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany, SCREEN, 2003-2004), after SCREEN (2004-2008), and nation-wide skin cancer screening (2008-2010)) to a reference region (Saarland, Germany). Age-standardized (Europe) NMSC incidence was 119/100,000 for women and 145/100,000 for men in the most recent screening period in Schleswig-Holstein (2008-2010). During implementation of SCREEN (2003-2004), incidence increased from 81.5/100,000 to 111.5/100,000 (1998-2000) by 47% for women and 34% for men. All age groups in women were affected by the increase, but increases for men were mostly limited to the older age groups. Incidence in Saarland first increased slowly, but increased steeply with the introduction of the nation-wide skin cancer screening in 2008 (+47% for women and +40% for men, reference 2004-2008). Observed changes are most likely attributed to screening activities.

  12. Transient interference of transmission and incidence

    CERN Document Server

    Pérez-Prieto, A L; Muga, J G

    2000-01-01

    Due to a transient quantum interference during a wavepacket collision with a potential barrier, a particular momentum, that depends on the potential parameters but is close to the initial average momentum, becomes suppressed. The hole left pushes the momentum distribution outwards leading to a significant constructive enhancement of lower and higher momenta. This is explained in the momentum complex-plane language in terms of a saddle point and two contiguous ``structural'' poles, which are not associated with resonances but with incident and transmitted components of the wavefunction.

  13. Cancer incidence among Danish brewery workers

    DEFF Research Database (Denmark)

    Thygesen, Lau Caspar; Johansen, Christoffer; Grønbaek, Morten;

    2005-01-01

    Since the foundation of the Danish Brewery Workers' Union (BWU) in 1898, an integrated issue in the labour contract between the BWU and the employers implied that the breweries provided 6 bottles of beer to each brewery worker per day. The objective of our study is to investigate if this presumably...... in a brewery between 1939 and 1963. From the original cohort of 14,313 workers, it was possible to identify 13,051 brewery workers (91.2%). The identified brewery workers were linked to the Danish Cancer Registry for any cancer diagnoses during 1943-1999. The incidence rate of all Danish men was applied...

  14. Film thickness determination by grazing incidence diffraction

    Energy Technology Data Exchange (ETDEWEB)

    Battiston, G. A.; Gerbasi, R. [CNR, Padua (Italy). Istituto di Chimica e Tecnologie Inorganiche e dei Materiali Avanzati

    1996-09-01

    Thin films deposited via MOCVD (Metal Organic Chemical Vapour Deposition) are layers in the thickness range of a few manometers to about ten micrometers. An understanding of the physics and chemistry of films is necessary for a better comprehension of the phenomena involved in the film deposition procedure and its optimisation. Together with the crystalline phase a parameter that must be determined is the thickness of the layer. In this work the authors present a method for the measurement of the film thickness. This procedure, based on diffraction intensity absorption of the X-rays, both incident and diffracted in passing through the layers, resulted quite simple, rapid and non-destructive.

  15. Incidence of actinomycosis associated with intrauterine devices.

    Science.gov (United States)

    Chatwani, A; Amin-Hanjani, S

    1994-08-01

    The incidence of intrauterine device (IUD)-associated cervicovaginal actinomycosis was evaluated. Papanicolaou-stained cervicovaginal smears from 1,520 women with IUDs were reviewed for the presence of Actinomyces-like organisms. The overall colonization rate was 11.4%. The colonization rates for the Progestasert, plastic IUDs and copper IUDs were 14.3%, 10.8% and 6.69%, respectively. The colonization rate appeared to increase with the duration of IUD use. The relatively high cervicovaginal Actinomyces colonization rate suggests that all patients with IUDs should undergo annual cytologic smears, with specific attention given to the presence of Actinomyces-like organisms.

  16. Planning to Plan-Integrating Control Flow

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    In many planning situations, computation itself becomes a resource to be planned and scheduled. We model such computational resources as conventional resources which are used by control-flow actions, e.g., to direct the planning process. Control-flow actions and conventional actions are planned/scheduled in an integrated way and can interact with each other. Control-flow actions are then executed by the planning engine itself. The approach is illustrated by examples, e.g., for hierarchical planning, in which tasks that are temporally still far away impose only rough constraints on the current schedule, and control-flow tasks ensure that these tasks are refined as they approach the current time. Using the same mechanism, anytime algorithms can change appropriate search methods or parameters over time, and problems like scheduling critical time-outs for garbage collection can be made part of the planning itself.

  17. Goal-oriented requirement engineering support for business continuity planning

    OpenAIRE

    Arenas, Alvaro; Massonet, Philippe; Ponsard, Christophe; Aziz, Benjamin

    2015-01-01

    Business continuity is a key management process that aims to maintain and rapidly recover an organizations key business functions in the face of serious incidents. The resulting business continuity plan must identify the key business functions that must be resilient, define recovery of critical business functions and define contingency measures when recovery is not possible. This paper argues that the process of business continuity planning can be efficiently supported by a goal-oriented requ...

  18. Financial planning

    OpenAIRE

    Χατζηγώγου, Αρτεμις Π.

    2003-01-01

    Σκοπός της μελέτης αυτής, είναι η συγκέντρωση όλων των στοιχείων εκείνων που συνθέτουν μια οργανωμένη διαδικασία έρευνας, που είναι γνωστή ως Financial Planning. Θα μπορούσαμε εναλλακτικά να πούμε, ότι βασικά ο χρηματοοικονομικός σχεδιασμός προγραμματίζει, εξευρίσκει και χρησιμοποιεί τα κεφάλαια με τέτοιο τρόπο ώστε η συνεισφορά τους να είναι μεγαλύτερη στην αποτελεσματική λειτουργία της οικονομικής μονάδας. Παρέχει τις γνώσεις των χρηματιστικών αγορών από όπου αντλούνται τα κεφάλαια. Οδηγεί ...

  19. Investigation of granulomatous prostatitis incidence following intravesical BCG therapy

    Science.gov (United States)

    Balasar, Mehmet; Doğan, Metin; Kandemir, Abdulkadir; Taskapu, Hakan Hakki; Cicekci, Faruk; Toy, Hatice; Gurbuz, Recai

    2014-01-01

    In the present manuscript, we studied the incidence of granulomatous prostatitis in the prostatectomy specimen of the patients who underwent transurethral resection of the prostate (TURP) after superficial bladder cancer treatment with intravesical Bacillus Calmette-Guerin (BCG) and were diagnosed with benign prostate hyperplasia (BPH). The clinical data and histopathological specimen records of 472 patients who underwent TUR-P due to BPH diagnosis, obtained over a period of 6 years in the urology department of Private Konya Hospital, Konya, Turkey, were studied retrospectively. The cases were divided into two groups as (Group I) who did not undergo any treatment and as (Group II) who underwent BCG treatment. The frequency and the clinical course of the cases with granulomatous prostatitis were studied histopathologically. There were in total 472 patients who underwent TUR-P. Out of the 459 patients who did not undergo BCG treatment (Group I), the histopathological specimen records of 262 (57%) was BPH, of 197 (43%) BPH + chronic prostatitis. Of the second group, 13 cases underwent intravesical BCG treatment before surgical intervention due to superficial bladder CA diagnosis. In this group 4 of the cases were diagnosed as (30%) BPH, 9 as (70%) chronic prostatitis + BPH. 6 out of the 9 chronic prostatitis cases were chronic prostatitis, 2 caseous granulomatous prostatitis, 1 non-caseous granulomatous prostatitis. Granulomatous prostatitis cases should require no specific therapy. Conclusion: In patients with obstruction complaints following intravesical BCG treatment, granulomatous prostatitis should also be considered and treatment plans should be made accordingly. PMID:25035779

  20. Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics

    Directory of Open Access Journals (Sweden)

    Janice Halpern

    2014-01-01

    Full Text Available Effective workplace-based interventions after critical incidents (CIs are needed for emergency medical technicians (EMT/paramedics. The evidence for a period out of service post-CI (downtime is sparse; however it may prevent posttraumatic stress disorder (PTSD and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores. Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

  1. Downtime after critical incidents in emergency medical technicians/paramedics.

    Science.gov (United States)

    Halpern, Janice; Maunder, Robert G; Schwartz, Brian; Gurevich, Maria

    2014-01-01

    Effective workplace-based interventions after critical incidents (CIs) are needed for emergency medical technicians (EMT)/paramedics. The evidence for a period out of service post-CI (downtime) is sparse; however it may prevent posttraumatic stress disorder (PTSD) and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores). Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

  2. Prevalence and incidence of systemic lupus erythematosus in the adult population of Estonia.

    Science.gov (United States)

    Otsa, K; Talli, S; Harding, P; Parsik, E; Esko, M; Teepere, A; Tammaru, M

    2017-01-01

    Studies have demonstrated considerable variability in systemic lupus erythematosus (SLE) incidence and prevalence estimates. Lack of reliable epidemiological data may hinder evidence-based health care planning. The aim of the present study was to estimate the prevalence and incidence of SLE in the Estonian adult population. The SLE billing cases were extracted from the Estonian Health Insurance Fund database 2006-2010 and verified using health care providers' databases. The patients' life status data for January 1, 2011, were retrieved from the Estonian Population Register. The calculations for the estimates' lower limits were based on verified cases only; the upper limits calculations also accounted for the billing cases for which clinical data were unavailable. The period prevalence of SLE was between 39 and 48 per 100,000 and incidence rate between 1.5 and 1.8 per 100,000 person-years. The point prevalence on January 1, 2011, was between 37 and 40 per 100,000. The estimates are comparable with internationally published figures and can be used to enhance evidence-based health care planning. The high percentage of billing cases that could not be verified using clinical data supports the argument that epidemiological studies based solely on administrative databases are usually of low reliability.

  3. Network Modeling of Crohn's Disease Incidence.

    Directory of Open Access Journals (Sweden)

    Jean-Marc Victor

    Full Text Available Numerous genetic and environmental risk factors play a role in human complex genetic disorders (CGD. However, their complex interplay remains to be modelled and explained in terms of disease mechanisms.Crohn's Disease (CD was modeled as a modular network of patho-physiological functions, each summarizing multiple gene-gene and gene-environment interactions. The disease resulted from one or few specific combinations of module functional states. Network aging dynamics was able to reproduce age-specific CD incidence curves as well as their variations over the past century in Western countries. Within the model, we translated the odds ratios (OR associated to at-risk alleles in terms of disease propensities of the functional modules. Finally, the model was successfully applied to other CGD including ulcerative colitis, ankylosing spondylitis, multiple sclerosis and schizophrenia.Modeling disease incidence may help to understand disease causative chains, to delineate the potential of personalized medicine, and to monitor epidemiological changes in CGD.

  4. Incidence of injury in kickboxing participation.

    Science.gov (United States)

    Romaine, Linda J; Davis, Shala E; Casebolt, Kevin; Harrison, Kelly A

    2003-08-01

    Cardio kickboxing classes have become a popular form of exercise to enhance fitness. This study surveyed kickboxing participants and instructors to ascertain the severity, type, and incidence of injuries sustained while performing cardio kickboxing exercise. The respondents consisted of 77.4% instructors and 29.3% participants with a mean age of 32.29 years (+/-8.98 years). Injury from kickboxing exercise was reported by 29.3% of the respondents, 31% of the instructors, and 15.5% of the participants. The most common site of injury for instructors was the back, followed by the knee, hip, and shoulder. The most common site of injury for participants was the back, knee, and ankle. Strains were the most common type of injury reported, followed by sprains and tendinitis. More than half of the injuries reported were new injuries (64%), with almost 59% of the total injuries reported causing a disruption of the normal exercise routine or an alteration of normal daily activities. Instructors who reported using music speeds greater than 140 beats per minute had a higher incidence of injury, compared with instructors who used music between 125 and 139 beats per minute. The wrist and elbow had the highest percentage of new injuries reported. This study suggests that kickboxing exercise can be a safe form of exercise for fitness purposes. Keeping music speeds below 140 beats per minute and limiting the number of kickboxing sessions per week may help to reduce injury rates.

  5. LEPTOSPIROSIS INCIDENCE AND MORTALITY IN MALAYSIA.

    Science.gov (United States)

    Tan, Wei Leong; Soelar, Shahrul Aiman; Mohd Suan, Mohd Azri; Hussin, Narwani; Cheah, Wee Kooi; Verasahib, Khebir; Goh, Pik Pin

    2016-05-01

    Leptospirosis is endemic in Southeast Asia, Central and South America, the Caribbean, and Oceania. Malaysia was categorized as a probable endemic country without any available data. Thus, this study was conducted to determine incidence, case fatality rate and mortality rate of leptospirosis. Leptospirosis is a notifiable disease in Malaysia since 2010 whereby probable or confirmed cases must be notified to relevant health district office. There were 3,665 and 4,457 probable and laboratory confirmed leptospirosis cases notified in 2012 and 2013, respectively. In the 2-year period, the most common age group of patients was 19 years old or less (23.3%) with male:female ratio of 2.61:1. Students consisted about 16.9% of patients, followed by agriculture-based or plantation workers (14.7%). Overall age-standardized incidence rate of leptospirosis in Malaysia for 2012 and 2013 was 29.02 per 100,000. Overall case fatality rate was 1.47% for 2-year period and overall age-standardized mortality rate was 0.45 per 100,000. Leptospirosis is an emerging public health concern in Malaysia and may pose a significant health impact and burden to the nation in the coming years if not well controlled.

  6. Incidence densities in a competing events analysis.

    Science.gov (United States)

    Grambauer, Nadine; Schumacher, Martin; Dettenkofer, Markus; Beyersmann, Jan

    2010-11-01

    Epidemiologists often study the incidence density (ID; also known as incidence rate), which is the number of observed events divided by population-time at risk. Its computational simplicity makes it attractive in applications, but a common concern is that the ID is misleading if the underlying hazard is not constant in time. Another difficulty arises if competing events are present, which seems to have attracted less attention in the literature. However, there are situations in which the presence of competing events obscures the analysis more than nonconstant hazards do. The authors illustrate such a situation using data on infectious complications in patients receiving stem cell transplants, showing that a certain transplant type reduces the infection ID but eventually increases the cumulative infection probability because of its effect on the competing event. The authors investigate the extent to which IDs allow for a reasonable analysis of competing events. They suggest a simple multistate-type graphic based on IDs, which immediately displays the competing event situation. The authors also suggest a more formal summary analysis in terms of a best approximating effect on the cumulative event probability, considering another data example of US women infected with human immunodeficiency virus. Competing events and even more complex event patterns may be adequately addressed with the suggested methodology.

  7. Cancer incidence in Australian Vietnam veterans

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, E.; Horsley, K. [Australian Government Department of Veterans' Affairs (Australia); Hoek, R. van der [Australian Institute of Health and Welfare (Australia)

    2004-09-15

    Australian Defence Force (ADF) personnel participated in the Vietnam Conflict from 1962 to 1973, involving nearly 60,000 personnel, of whom over 500 died during service and 3131 were severely physically wounded. Service in the Vietnam conflict presented distinct health challenges. Besides the hazards of combat conditions for extended periods, herbicides and other toxic chemicals were used extensively. The United States military sprayed more than 76,000,000L of herbicide over Vietnam in their Air Force Ranch Hand and Operation Trail Dust programs. The most heavily used herbicide was Agent Orange, contaminated with 2,3,7,8-tetrachlorodibenzo-pdioxin. Since the Vietnam conflict, ex-Service organisations (ESOs) have maintained that Vietnam service adversely affected the health of veterans. Initial studies showed no excess risk attributable to their service. However, more recent studies have shown that Vietnam veterans have excess incidence and mortality rates from several conditions such as cancers and heart disease. This paper describes the first cancer incidence study for all ADF Vietnam veterans.

  8. The critical incident inventory: characteristics of incidents which affect emergency medical technicians and paramedics

    Directory of Open Access Journals (Sweden)

    Halpern Janice

    2012-08-01

    Full Text Available Abstract Background Emergency medical technicians (EMTs and paramedics experience critical incidents which evoke distress and impaired functioning but it is unknown which aspects of incidents contribute to their impact. We sought to determine these specific characteristics by developing an inventory of critical incident characteristics and testing their relationship to protracted recovery from acute stress, and subsequent emotional symptoms. Methods EMT/paramedics (n = 223 completed a retrospective survey of reactions to an index critical incident, and current depressive, posttraumatic and burnout symptoms. Thirty-six potential event characteristics were evaluated; 22 were associated with peritraumatic distress and were retained. We assigned inventory items to one of three domains: situational, systemic or personal characteristics. We tested the relationships between (a endorsing any domain item and (b outcomes of the critical incident (peritraumatic dissociation, recovery from components of the Acute Stress Reaction and depressive, posttraumatic, and burnout symptoms. Analyses were repeated for the number of items endorsed. Results Personal and situational characteristics were most frequently endorsed. The personal domain had the strongest associations, particularly with peritraumatic dissociation, prolonged distressing feelings, and current posttraumatic symptoms. The situational domain was associated with peritraumatic dissociation, prolonged social withdrawal, and current posttraumatic symptoms. The systemic domain was associated with peritraumatic dissociation and prolonged irritability. Endorsing multiple characteristics was related to peritraumatic, acute stress, and current posttraumatic symptoms. Relationships with outcome variables were as strong for a 14-item inventory (situational and personal characteristics only as the 22-item inventory. Conclusions Emotional sequelae are associated most strongly with EMT/paramedics’ personal

  9. Nontuberculous Pulmonary Mycobacteriosis in Denmark: Incidence and Prognostic Factors

    DEFF Research Database (Denmark)

    Andréjak, Claire; Thomsen, Vibeke O; Johansen, Isik S;

    2010-01-01

    RATIONALE: Few population-based data are available regarding nontuberculous mycobacteria (NTM) pulmonary disease epidemiology and prognosis. OBJECTIVES: To examine NTM pulmonary colonization incidence, disease incidence, and prognostic factors. METHODS: All adults in Denmark with at least one NTM...

  10. Numerical method for angle-of-incidence correction factors for diffuse radiation incident photovoltaic modules

    Energy Technology Data Exchange (ETDEWEB)

    Marion, Bill

    2017-05-01

    A numerical method is provided for solving the integral equation for the angle-of-incidence (AOI) correction factor for diffuse radiation incident photovoltaic (PV) modules. The types of diffuse radiation considered include sky, circumsolar, horizon, and ground-reflected. The method permits PV module AOI characteristics to be addressed when calculating AOI losses associated with diffuse radiation. Pseudo code is provided to aid users in the implementation, and results are shown for PV modules with tilt angles from 0 degrees to 90 degrees. Diffuse AOI losses are greatest for small PV module tilt angles. Including AOI losses associated with the diffuse irradiance will improve predictions of PV system performance.

  11. Epidemiology of stroke in the elderly in the Nordic countries. Incidence, survival, prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Torgeir Engstad

    2012-11-01

    Full Text Available Objective: To review what is known at present with respect to incidence, survival, risk factors and prevalence among the elderly stroke patients in the Nordic countries.Method: This article is based mainly on literature identified through search engines (Mc Master Plus, Cochrane Library, Medline and PubMed, restricted to first-ever stroke in Nordic population-based studies and having applied to the standard WHO definition, a prospective study design and no upper age limit.Results: Data from the Nordic countries show an incidence rate of 1250 to 1796/100 000 in the age group 75-84, and 1628 to 2234 in those above 85 years. The incidence rates are higher among men, but women are expected to contribute more to incident cases due to their higher life expectancy. If the age-specific incidence of stroke remains stable, the proportion of stroke patients aged 80 years and older may reach 50% in a few decades. The elderly stroke patients have a higher 30-days case fatality, and a higher risk of dependency. Better treatment of stroke patients has improved the survival over the last two decades. The prevalence is expected to increase due to the decrease in lethality, a slower fall in incidence and a higher proportion of elderly. Cardiovascular risk factors increase with age. Hypertension is a major risk factor for stroke mortality in the elderly. Cardioembolic stroke due to atrial fibrillation is the most common stroke subtype in the elderly. Lifestyle risk factors are less prevalent in the older stroke patients.Conclusion: The growing proportion of elderly stroke patients is a major challenge for future stroke care. The elderly stroke patients have a different risk factor profile compared to younger stroke patients. Treatment should focus on regaining independency. The age-specific epidemiology of stroke needs to be studied further in large studies in order to plan for future health care.

  12. Energy Management Plan.

    Science.gov (United States)

    Tasmania Dept. of Education, Hobart (Australia). Facilities Services Section.

    This report presents an overview of the energy management plan for Tasmanian schools designed to minimize the costs of all forms of energy usage within these facilities. The policy and objectives of the plan are provided along with details of the plan itself and its current status. Appendices contain an extract from Asset Management Plan for Real…

  13. Conditional Epistemic Planning

    DEFF Research Database (Denmark)

    Andersen, Mikkel Birkegaard; Bolander, Thomas; Jensen, Martin Holm

    2012-01-01

    Recent work has shown that Dynamic Epistemic Logic (DEL) offers a solid foundation for automated planning under partial observability and non-determinism. Under such circumstances, a plan must branch if it is to guarantee achieving the goal under all contingencies (strong planning). Without...... branching, plans can offer only the possibility of achieving the goal (weak planning). We show how to formulate planning in uncertain domains using DEL and give a language of conditional plans. Translating this language to standard DEL gives verification of both strong and weak plans via model checking....... In addition to plan verification, we provide a tableau-inspired algorithm for synthesising plans, and show this algorithm to be terminating, sound and complete....

  14. Critical Incidents in Multicultural Training: An Examination of Student Experiences

    Science.gov (United States)

    Coleman, M. Nicole

    2006-01-01

    This study examined critical incidents in graduate students' multicultural counseling training. Trainees (N=59) were asked to describe a critical incident and their multicultural training environment by responding to a critical incident protocol and the multicultural environment Inventory-Revised (D. B. Pope-Davis, W. M. Liu, J. Nevitt, & R. L.…

  15. Teachers' Critical Incidents: Ethical Dilemmas in Teaching Practice

    Science.gov (United States)

    Shapira-Lishchinsky, Orly

    2011-01-01

    The aim of this study is to explore ethical dilemmas in critical incidents and the emerged responses that these incidents elicit. Most teachers try to suppress these incidences because of the unpleasant feelings they evoke. Fifty teachers participated in the study. A three-stage coding process derived from grounded theory was utilized. A taxonomy…

  16. Incident Duration Modeling Using Flexible Parametric Hazard-Based Models

    Directory of Open Access Journals (Sweden)

    Ruimin Li

    2014-01-01

    Full Text Available Assessing and prioritizing the duration time and effects of traffic incidents on major roads present significant challenges for road network managers. This study examines the effect of numerous factors associated with various types of incidents on their duration and proposes an incident duration prediction model. Several parametric accelerated failure time hazard-based models were examined, including Weibull, log-logistic, log-normal, and generalized gamma, as well as all models with gamma heterogeneity and flexible parametric hazard-based models with freedom ranging from one to ten, by analyzing a traffic incident dataset obtained from the Incident Reporting and Dispatching System in Beijing in 2008. Results show that different factors significantly affect different incident time phases, whose best distributions were diverse. Given the best hazard-based models of each incident time phase, the prediction result can be reasonable for most incidents. The results of this study can aid traffic incident management agencies not only in implementing strategies that would reduce incident duration, and thus reduce congestion, secondary incidents, and the associated human and economic losses, but also in effectively predicting incident duration time.

  17. Incident duration modeling using flexible parametric hazard-based models.

    Science.gov (United States)

    Li, Ruimin; Shang, Pan

    2014-01-01

    Assessing and prioritizing the duration time and effects of traffic incidents on major roads present significant challenges for road network managers. This study examines the effect of numerous factors associated with various types of incidents on their duration and proposes an incident duration prediction model. Several parametric accelerated failure time hazard-based models were examined, including Weibull, log-logistic, log-normal, and generalized gamma, as well as all models with gamma heterogeneity and flexible parametric hazard-based models with freedom ranging from one to ten, by analyzing a traffic incident dataset obtained from the Incident Reporting and Dispatching System in Beijing in 2008. Results show that different factors significantly affect different incident time phases, whose best distributions were diverse. Given the best hazard-based models of each incident time phase, the prediction result can be reasonable for most incidents. The results of this study can aid traffic incident management agencies not only in implementing strategies that would reduce incident duration, and thus reduce congestion, secondary incidents, and the associated human and economic losses, but also in effectively predicting incident duration time.

  18. What is the real incidence of vestibular schwannoma?

    DEFF Research Database (Denmark)

    Tos, Mirko; Stangerup, Sven-Eric; Cayé-Thomasen, Per;

    2004-01-01

    OBJECTIVES: To present the incidence of vestibular schwannoma (VS) in Denmark, compare the incidence with that of previous periods, and discuss the real incidence of VS. DESIGN, SETTING, AND PATIENTS: Prospective registration of all diagnosed VS in Denmark, with a population of 5.1 to 5.2 million...

  19. Cancer incidence and incidence rates in Japan in 2008: a study of 25 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project.

    Science.gov (United States)

    Matsuda, Ayako; Matsuda, Tomohiro; Shibata, Akiko; Katanoda, Kota; Sobue, Tomotaka; Nishimoto, Hiroshi

    2014-04-01

    The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2008 based on data collected from 25 of 34 population-based cancer registries, as part of the Monitoring of Cancer Incidence in Japan project. The incidence in Japan for 2008 was estimated to be 749 767 (C00-C96). Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively.

  20. Marketing Planning: Feeniks Koulu

    OpenAIRE

    Raut, Biranjan

    2013-01-01

    Degree Thesis “Marketing Planning: Feeniks Koulu” demonstrates structured marketing planning process with the help of case company “Feeniks Koulu”. The central idea of Thesis is to come up with systematic marketing plan following structured process. Thesis employs qualitative research methodology following inductive reasoning approach. Thesis, initiates by outlining theoretical planning methods, which then is materialized into marketing plan with the help of empirical research. Discussion and...

  1. SPATIAL-TEMPORAL DYNAMICS OF URBAN FIRE INCIDENTS: A CASE STUDY OF NANJING, CHINA

    Directory of Open Access Journals (Sweden)

    J. Yao

    2016-06-01

    Full Text Available Fire and rescue service is one of the fundamental public services provided by government in order to protect people, properties and environment from fires and other disasters, and thus promote a safer living environment. Well understanding spatial-temporal dynamics of fire incidents can offer insights for potential determinants of various fire events and enable better fire risk estimation, assisting future allocation of prevention resources and strategic planning of mitigation programs. Using a 12-year (2002-2013 dataset containing the urban fire events in Nanjing, China, this research explores the spatial-temporal dynamics of urban fire incidents. A range of exploratory spatial data analysis (ESDA approaches and tools, such as spatial kernel density and co-maps, are employed to examine the spatial, temporal and spatial-temporal variations of the fire events. Particular attention has been paid to two types of fire incidents: residential properties and local facilities, due to their relatively higher occurrence frequencies. The results demonstrated that the amount of urban fire has greatly increased in the last decade and spatial-temporal distribution of fire events vary among different incident types, which implies varying impact of potential influencing factors for further investigation.

  2. Spatial-Temporal Dynamics of Urban Fire Incidents: a Case Study of Nanjing, China

    Science.gov (United States)

    Yao, J.; Zhang, X.

    2016-06-01

    Fire and rescue service is one of the fundamental public services provided by government in order to protect people, properties and environment from fires and other disasters, and thus promote a safer living environment. Well understanding spatial-temporal dynamics of fire incidents can offer insights for potential determinants of various fire events and enable better fire risk estimation, assisting future allocation of prevention resources and strategic planning of mitigation programs. Using a 12-year (2002-2013) dataset containing the urban fire events in Nanjing, China, this research explores the spatial-temporal dynamics of urban fire incidents. A range of exploratory spatial data analysis (ESDA) approaches and tools, such as spatial kernel density and co-maps, are employed to examine the spatial, temporal and spatial-temporal variations of the fire events. Particular attention has been paid to two types of fire incidents: residential properties and local facilities, due to their relatively higher occurrence frequencies. The results demonstrated that the amount of urban fire has greatly increased in the last decade and spatial-temporal distribution of fire events vary among different incident types, which implies varying impact of potential influencing factors for further investigation.

  3. Comparison of infant malaria incidence in districts of Maputo province, Mozambique

    Directory of Open Access Journals (Sweden)

    Zacarias Orlando P

    2011-04-01

    Full Text Available Abstract Background Malaria is one of the principal health problems in Mozambique, representing 48% of total external consultations and 63% of paediatric hospital admissions in rural and general hospitals with 26.7% of total mortality. Plasmodium falciparum is responsible for 90% of all infections being also the species associated with most severe cases. The aim of this study was to identify zones of high malaria risk, showing their spatially and temporal pattern. Methods Space and time Poison model for the analysis of malaria data is proposed. This model allows for the inclusion of environmental factors: rainfall, temperature and humidity as predictor variables. Modelling and inference use the fully Bayesian approach via Markov Chain Monte Carlo (MCMC simulation techniques. The methodology is applied to analyse paediatric data arising from districts of Maputo province, Mozambique, between 2007 and 2008. Results Malaria incidence risk is greater for children in districts of Manhiça, Matola and Magude. Rainfall and humidity are significant predictors of malaria incidence. The risk increased with rainfall (relative risk - RR: .006761, 95% interval: .001874, .01304, and humidity (RR: .049, 95% interval: .03048, .06531. Malaria incidence was found to be independent of temperature. Conclusions The model revealed a spatial and temporal pattern of malaria incidence. These patterns were found to exhibit a stable malaria transmission in most non-coastal districts. The findings may be useful for malaria control, planning and management.

  4. Materials released from spill incidents reported to Iowa DNR and tracked in the Hazardous Substance Incident database

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Materials released from spill incidents reported to Iowa DNR and tracked in the Hazardous Substance Incident database. These Emergency Release Notifications are...

  5. Incident Occurrence Modeling during Hurricane Evacuation Events: The Case of Alabama's I-65 Corridor

    Directory of Open Access Journals (Sweden)

    Daniel J. Fonseca

    2013-01-01

    Full Text Available Contraflow on major evacuation routes is one scheme that has been adopted in many Gulf and eastern coastal states for hurricane evacuation. The idea is to reverse one direction of the roadway in order to accommodate the often substantially increased travel demand moving away from the impact area. Efficient planning and operation is critical to a successful contraflow implementation. Alabama has an approximately 140-mile contraflow segment on I-65 between exit 31 and exit 167 and has carried out contraflow operations several times in past hurricane evacuations. The timing for the deployment of equipment and personnel and the initiation and termination of actual contraflow affects the effectiveness, safety, and cost of the operation. Researchers from the University of Alabama were tasked with the design of a decision support system for contraflow evacuation planning. The conceived decision support system consists of three main modules: the demand module, the network optimization module, and the incident and characterization module. This paper focuses on the design of the traffic incident generation and characterization module of the planned decision support system.

  6. Optimal multi-agent path planning for fast inverse modeling in UAV-based flood sensing applications

    KAUST Repository

    Abdelkader, Mohamed

    2014-05-01

    Floods are the most common natural disasters, causing thousands of casualties every year in the world. In particular, flash flood events are particularly deadly because of the short timescales on which they occur. Unmanned air vehicles equipped with mobile microsensors could be capable of sensing flash floods in real time, saving lives and greatly improving the efficiency of the emergency response. However, of the main issues arising with sensing floods is the difficulty of planning the path of the sensing agents in advance so as to obtain meaningful data as fast as possible. In this particle, we present a fast numerical scheme to quickly compute the trajectories of a set of UAVs in order to maximize the accuracy of model parameter estimation over a time horizon. Simulation results are presented, a preliminary testbed is briefly described, and future research directions and problems are discussed. © 2014 IEEE.

  7. Cognitive impairments are different in single-incidence and multi-incidence ADHD families

    NARCIS (Netherlands)

    Oerlemans, Anoek M.; Hartman, Catharina A.; de Bruijn, Yvette G. E.; Franke, Barbara; Buitelaar, Jan K.; Rommelse, Nanda N. J.

    2015-01-01

    BackgroundWe may improve our understanding of the role of common versus unique risk factors in attention-deficit/hyperactivity disorder (ADHD) by examining ADHD-related cognitive deficits in single- (SPX), and multi-incidence (MPX) families. Given that individuals from multiplex (MPX) families are l

  8. Cognitive Impairments Are Different in Single-Incidence and Multi-Incidence ADHD Families

    Science.gov (United States)

    Oerlemans, Anoek M.; Hartman, Catharina A.; Bruijn, Yvette G. E.; Franke, Barbara; Buitelaar, Jan K.; Rommelse, Nanda N. J.

    2015-01-01

    Background: We may improve our understanding of the role of common versus unique risk factors in attention-deficit/hyperactivity disorder (ADHD) by examining ADHD-related cognitive deficits in single- (SPX), and multi-incidence (MPX) families. Given that individuals from multiplex (MPX) families are likely to share genetic vulnerability for the…

  9. Electromagnetic parameter retrieval at oblique incidence

    Science.gov (United States)

    Khan, Saima I.; De La Rue, Richard M.; Drysdale, Tim D.; Johnson, Nigel P.

    2013-05-01

    Optical metamaterials are able to achieve optical properties that do not exist in nature. Approaches to the homogenization of optical metamaterials are becoming more and more complex in the desire to achieve accurate representation. Here we propose to modify an existing retrieval approach for metamaterials to characterize their properties. To extract the effective refractive index and material parameters from reflection and transmission coefficients for double negative metamaterial in the optical regime, the modified Nicholson-Ross-Weir (NRW) method is used. In order to obtain a true picture of these metamaterials, as a function of angle of incidence of the illumination, it is important to present not only the effective parameters of permittivity and permeability but also some other important parameters such as coupling coefficients, that represent the inherent anisotropy.

  10. The Metallicity Dependence of Giant Planet Incidence

    CERN Document Server

    Gonzalez, Guillermo

    2014-01-01

    We describe three corrections that should be applied to the observed relative incidence of nearby stars hosting giant planets. These are diffusion in the stellar atmosphere, use of the [Ref] index in place of [Fe/H] for metallicity, and correction for local sampling with the W velocity. We have applied these corrections to a subset of the SPOCS exoplanet survey with uniform giant planet detectability. Fitting the binned data to a power law of the form, $\\alpha 10^{\\beta [Fe/H]}$, we derived $\\alpha = 0.022 \\pm 0.007$ and $\\beta = 3.0 \\pm 0.5$; this value of $\\beta$ is 50\\% larger than the value determined by \\citet{fv05}. While the statistical significance of this difference is marginal, given the small number statistics, these corrections should be included in future analyses that include larger samples.

  11. High Injury Incidence in Adolescent Female Soccer

    DEFF Research Database (Denmark)

    Clausen, Mikkel Bek; Zebis, Mette Kreutzfeldt; Møller, Merete

    2014-01-01

    BACKGROUND: Previous studies report varying rates of time-loss injuries in adolescent female soccer, ranging from 2.4 to 5.3 per 1000 athlete-exposures or 2.5 to 3.7 per 1000 hours of exposure. However, these studies collected data using traditional injury reports from coaches or medical staff......, with methods that significantly underestimate injury rates compared with players' self-reports. PURPOSE: The primary aim was to investigate the injury incidence in adolescent female soccer using self-reports via mobile telephone text messaging. The secondary aim was to explore the association between soccer...... exposure, playing level, and injury risk. STUDY DESIGN: Descriptive epidemiology study and cohort study; Level of evidence, 2 and 3. METHODS: During a full adolescent female soccer season in Denmark (February-June 2012), a population-based sample of 498 girls aged 15 to 18 years was included...

  12. Normal Incidence for Graded Index Surfaces

    Science.gov (United States)

    Khankhoje, Uday K.; Van Zyl, Jakob

    2011-01-01

    A plane wave is incident normally from vacuum (eta(sub 0) = 1) onto a smooth surface. The substrate has three layers; the top most layer has thickness d(sub 1) and permittivity epsilon(sub 1). The corresponding numbers for the next layer are d(sub 2); epsilon(sub 2), while the third layer which is semi-in nite has index eta(sub 3). The Hallikainen model [1] is used to relate volumetric soil moisture to the permittivity. Here, we consider the relation for the real part of the permittivity for a typical loam soil: acute epsilon(mv) = 2.8571 + 3.9678 x mv + 118:85 x mv(sup 2).

  13. Discontinuation of denosumab and associated fracture incidence

    DEFF Research Database (Denmark)

    Brown, Jacques P; Roux, Christian; Törring, Ove;

    2012-01-01

    Osteoporosis is a chronic disease and requires long-term treatment with pharmacologic therapy to ensure sustained anti-fracture benefit. Denosumab reduced the risk for new vertebral, nonvertebral, and hip fractures over 36 months in the FREEDOM trial. While discontinuation of denosumab has been...... associated with transient increases in bone remodeling and declines in bone mineral density (BMD), the effect on fracture risk during treatment cessation is not as well characterized. To understand the fracture incidence between treatment groups after cessation of investigational product, we evaluated...... of 797 subjects (470 placebo, 327 denosumab), who were evaluable during the off-treatment period, showed similar baseline characteristics for age, prevalent fracture, and lumbar spine and total hip BMD T-scores. During treatment, more placebo-treated subjects as compared with denosumab-treated subjects...

  14. Case Studies in Strategic Planning

    Science.gov (United States)

    1990-03-06

    Contains developed case studies in strategic planning on The Navy General Board, Joint Service War Planning 1919 to 1941, Navy Strategic Planning , NASA...in Strategic Planning NPS-56-88-031-PR of September 1988. Strategic planning , Strategic Management.

  15. Laser Incident Lessons Learned and Action List

    Energy Technology Data Exchange (ETDEWEB)

    Yarotski, Dmitry Anatolievitch [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-02-29

    On Thursday November 19, 2015, LANL postdoc received an eye injury from a reflected, nonvisible laser beam (Class 4, pulsed, wavelength 800 nanometer). The setup is configured to split the laser output into two work areas in which qualified operators conduct research experiments. During this incident, the laser output beam was being projected to both experimental work areas, although only one experimental area was actively being used. The second laser beam directed to the second work area was blocked by an inappropriate device (Plexiglas, reflective, non-normal incidence) that reflected substantial portion of the beam toward the first setup. In preparation for the measurements, worker stepped on the stepstool and decided to remove the laser goggles to better see the micrometer readings which were difficult to see due to insufficient lighting. Immediately, he noticed a flash of light in his eye. The operator quickly replaced the laser eye-wear and then, using an infrared viewer, located a stray laser beam being reflected from the plexiglas beam block. The operator did not think he had sustained any injury and continued working. Later that day, however, he noticed a blurry spot in the vision of his left eye. He notified his supervisor on Friday morning, November 20, 2015, and was taken by CINT management to Sandia National Laboratories (SNL) medical facility for evaluation. SNL Medical did not find any abnormalities, but referred the operator to a local ophthalmologist for further evaluation. Further evaluations by the ophthalmologist on November 21 and November 23 identified a small spot of inflammation near the fovea on the retina in his left eye. The ophthalmologist stated that this spot would most likely heal on its own and that the blurry spot on the operator's vision would go away. A follow-up visit was scheduled. The employee was released back to work without restrictions.

  16. Perceptions and Incidence of Test Anxiety

    Directory of Open Access Journals (Sweden)

    Travis G. Gerwing

    2015-12-01

    Full Text Available Test anxiety (TA can lower student GPA and increase dropout rates in populations of university students. Despite numerous treatment options, many students still suffer from TA. The stigma attached to this type of anxiety and the incidence rates and perceptions of TA were quantified through surveys distributed to 1,099 students at a Canadian university. Results of this study indicated that 38.5% of students (30.0 % of males, 46.3 % of females suffered from self-reported TA at some point over the course of their university career. The prevalence of TA varied by faculty, with the highest incidence among those students enrolled concurrently in Arts and Science, and Nursing students. While student perceptions varied by age, sex, and experience with TA, one third of students expressed negative and inaccurate views about TA. These negative perceptions may explain why 11.3% of surveyed students indicated they would not seek help for their TA as, for many, to do so would make them seem weak in the eyes of their colleagues. Further, 20.5% of students surveyed reported that they believe professors would be unable or unwilling to help. It may be the case that this negative perception towards TA makes it difficult for faculty and helping professionals to identify and intervene effectively. Faculty specific educational campaigns designed to educate students about TA, in particular about its prevalence and severity, are suggested as a method to circumvent the negative stigma surrounding this condition. Implementation of such educational policies will likely improve the educational experience and performance of students with TA, as well as improve student retention.

  17. [Cancer incidence and mortality in some health districts in Brescia area 1993--1995].

    Science.gov (United States)

    Simonati, C; Limina, R M; Gelatti, U; Indelicato, A; Scarcella, C; Donato, F; Nardi, G

    2004-01-01

    Cancer Registries are an essential part of any rational programme of cancer control, for assessing the impact of cancer in the community, for health care planning and monitoring screening programmes, according to local enviromental problems. The Brescia Cancer Registry started in 1994 producing prevalence, incidence and mortality data using only manual procedures of colletting and processing data from clinical and pathological sources in Brescia in 1993--1995. Data quality indicators such as the percentages of istologically or cytologically verified cases and that of cases registered on the basis of Death Certificate Only (DCO) are similar to those from the other Northern Italian Registries. Incidence rates for all causes and for various common sites are higher in Brescia than in other areas covered by Cancer Registries in North of Italy.

  18. A model supporting Business Continuity auditing & planning in Information Systems

    NARCIS (Netherlands)

    Zambon, Emmanuele; Bolzoni, Damiano; Etalle, Sandro; Salvato, Marco

    2007-01-01

    One of the main tasks of IT business continuity planning (BCP) is to guarantee that incidents affecting the IT infrastructure do not affect the availability of IT-dependent business processes beyond a given acceptable extent. Carrying out BCP of information systems is particularly challenging, becau

  19. Epidemiology of Road Traffic Incidents in Peru 1973–2008: Incidence, Mortality, and Fatality

    Science.gov (United States)

    Miranda, J. Jaime; López-Rivera, Luis A.; Quistberg, D. Alex; Rosales-Mayor, Edmundo; Gianella, Camila; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Paca, Ada; Luis, López; Luna, Diego; Rosales, Edmundo; Best, Pablo; Best, Pablo; Egúsquiza, Miriam; Gianella, Camila; Lema, Claudia; Ludeña, Esperanza; Miranda, J. Jaime; Huicho, Luis

    2014-01-01

    Background The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973–2008, as well as their relationship to population trends such as economic growth. Methods and Findings Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43–5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15–0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09–1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita Conclusions The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs. PMID:24927195

  20. Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.

    Directory of Open Access Journals (Sweden)

    J Jaime Miranda

    Full Text Available The epidemiological profile and trends of road traffic injuries (RTIs in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth.Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31 on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43, while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43. Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP per capita.The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.