Medical Surveillance Monthly Report (MSMR). Volume 16, Number 10, October 2009

DTIC Science & Technology

2009-10-01

Iraqi Freedom, active component, U.S.Armed Forces ____________________________________2 Medical evacuation for suspected breast cancer , active and...Suspected Breast Cancer , Active and Reserve Components, U.S. Armed Forces, January 2002-June 2009 Deployment health” activities enable the Armed Forces to...members medically evacuated from Iraq or Afghanistan since 2002 with a diagnosis of a breast lump, breast cancer or other breast disorders. The

Accuracy of Four Imaging Techniques for Diagnosis of Posterior Pelvic Floor Disorders.

PubMed

van Gruting, Isabelle M A; Stankiewicz, Aleksandra; Kluivers, Kirsten; De Bin, Riccardo; Blake, Helena; Sultan, Abdul H; Thakar, Ranee

2017-11-01

To establish the diagnostic test accuracy of evacuation proctography, magnetic resonance imaging (MRI), transperineal ultrasonography, and endovaginal ultrasonography for detecting posterior pelvic floor disorders (rectocele, enterocele, intussusception, and anismus) in women with obstructed defecation syndrome and secondarily to identify the most patient-friendly imaging technique. In this prospective cohort study, 131 women with symptoms of obstructed defecation syndrome underwent evacuation proctogram, MRI, and transperineal and endovaginal ultrasonography. Images were analyzed by two blinded observers. In the absence of a reference standard, latent class analysis was used to assess diagnostic test accuracy of multiple tests with area under the curve (AUC) as the primary outcome measure. Secondary outcome measures were interobserver agreement calculated as Cohen's κ and patient acceptability using a visual analog scale. No significant differences in diagnostic accuracy were found among the imaging techniques for all the target conditions. Estimates of diagnostic test accuracy were highest for rectocele using MRI (AUC 0.79) or transperineal ultrasonography (AUC 0.85), for enterocele using transperineal (AUC 0.73) or endovaginal ultrasonography (AUC 0.87), for intussusception using evacuation proctography (AUC 0.76) or endovaginal ultrasonography (AUC 0.77), and for anismus using endovaginal (AUC 0.95) or transperineal ultrasonography (AUC 0.78). Interobserver agreement for the diagnosis of rectocele (κ 0.53-0.72), enterocele (κ 0.54-0.94) and anismus (κ 0.43-0.81) was moderate to excellent, but poor to fair for intussusception (κ -0.03 to 0.37) with all techniques. Patient acceptability was better for transperineal and endovaginal ultrasonography as compared with MRI and evacuation proctography (P<.001). Evacuation proctography, MRI, and transperineal and endovaginal ultrasonography were shown to have similar diagnostic test accuracy. Evacuation proctography is not the best available imaging technique. There is no one optimal test for the diagnosis of all posterior pelvic floor disorders. Because transperineal and endovaginal ultrasonography have good test accuracy and patient acceptability, we suggest these could be used for initial assessment of obstructed defecation syndrome. ClinicalTrials.gov, NCT02239302.

High-resolution Anorectal Manometry for Identifying Defecatory Disorders and Rectal Structural Abnormalities in Women.

PubMed

Prichard, David O; Lee, Taehee; Parthasarathy, Gopanandan; Fletcher, Joel G; Zinsmeister, Alan R; Bharucha, Adil E

2017-03-01

Contrary to conventional wisdom, the rectoanal gradient during evacuation is negative in many healthy people, undermining the utility of anorectal high-resolution manometry (HRM) for diagnosing defecatory disorders. We aimed to compare HRM and magnetic resonance imaging (MRI) for assessing rectal evacuation and structural abnormalities. We performed a retrospective analysis of 118 patients (all female; 51 with constipation, 48 with fecal incontinence, and 19 with rectal prolapse; age, 53 ± 1 years) assessed by HRM, the rectal balloon expulsion test (BET), and MRI at Mayo Clinic, Rochester, Minnesota, from February 2011 through March 2013. Thirty healthy asymptomatic women (age, 37 ± 2 years) served as controls. We used principal components analysis of HRM variables to identify rectoanal pressure patterns associated with rectal prolapse and phenotypes of patients with prolapse. Compared with patients with normal findings from the rectal BET, patients with an abnormal BET had lower median rectal pressure (36 vs 22 mm Hg, P = .002), a more negative median rectoanal gradient (-6 vs -29 mm Hg, P = .006) during evacuation, and a lower proportion of evacuation on the basis of MRI analysis (median of 40% vs 80%, P < .0001). A score derived from rectal pressure and anorectal descent during evacuation and a patulous anal canal was associated (P = .005) with large rectoceles (3 cm or larger). A principal component (PC) logistic model discriminated between patients with and without prolapse with 96% accuracy. Among patients with prolapse, there were 2 phenotypes, which were characterized by high (PC1) or low (PC2) anal pressures at rest and squeeze along with higher rectal and anal pressures (PC1) or a higher rectoanal gradient during evacuation (PC2). In a retrospective analysis of patients assessed by HRM, measurements of rectal evacuation by anorectal HRM, BET, and MRI were correlated. HRM alone and together with anorectal descent during evacuation may identify rectal prolapse and large rectoceles, respectively, and also identify unique phenotypes of rectal prolapse. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

[Travel and psychotic disorders: clinical aspects and practical recommendations].

PubMed

Vermersch, Charles; Geoffroy, Pierre Alexis; Fovet, Thomas; Thomas, Pierre; Amad, Ali

2014-12-01

Psychotic disorders are frequent among travelers (10 to 20 % of medical evacuations). The travel is a concentrate of stressors. Psychotic disorders are not a contraindication to travel. Special precautions should be taken for patients with psychotic disorders wishing to travel. These precautions could apply to patients at risk of transition to a psychotic disorder. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Loss of Life, Evacuation and Emergency Management - Application of Dutch Models to US Case Studies

DTIC Science & Technology

2012-12-18

Risks to people M es o: Z on e or lo ca tio n Instability tests Jonkman 1953 D eK ay a nd M cC le lla nd G ra ha m Katrina HEC -FIA...mortality functions (Jonkman) o 2.2.2 New Orleans / Katrina mortality functions (Jonkman) o 2.2.3 HEC FIA approach (USACE) o 2.2.4. Loss of life methods...comparison (USACE) • 2.3 Dutch Evacuation and Evacuaid approach (Kolen) o 2.3.1 Evacuation approach implemented in HEC FIA (USACE) o 2.3.2 Evacuation

Is ideology a risk factor for PTSD symptom severity among Israeli political evacuees?

PubMed

Oren, Lior; Possick, Chaya

2010-08-01

To study the role of ideology in situations of extreme stress, a research questionnaire, measuring posttraumatic stress disorder (PTSD), settlement ideology (the importance of Jewish settlement in Gaza), and type of evacuation was administered to 326 Jewish residents who were evacuated from Gaza settlements by the Israeli government. Forty percent of the participants met the criteria of probable PTSD. Forcibly evicted individuals reported higher levels of settlement ideology and higher levels of PTSD symptom severity compared to voluntarily evacuated individuals. Contrary to previous studies, ideology was found to be positively associated with PTSD symptom severity. The results are explained by the conservation of resources and terror management theories. Theoretical and practical implications are discussed.

[Connective tissue dysplasia in patients with celiac desease as a problem of violation of adaptation reserve islands of the body].

PubMed

Tkachenko, E; Oreshko, L S; Soloveva, E A; Shabanova, A A; Zhuravleva, M S

2015-01-01

Clinically significant dysplasia of connective tissue in patients with celiac disease is often responsible for various visceral disorders. Different disturbances of motor and evacuation functions are often determined in this patients (gastroesophageal reflux, duodenogastral reflux, spastic and hyperkinetic dyskinesia). The clinical course of the celiac disease, associated with connective tissue dysplasia, is characterized by asthenovegetative syndrome, reduced tolerance to physical activity, general weakness, fatigue and emotional instability. These data should be considered in choosing a treatment.

Factors Affecting Hurricane Evacuation Intentions.

PubMed

Lazo, Jeffrey K; Bostrom, Ann; Morss, Rebecca E; Demuth, Julie L; Lazrus, Heather

2015-10-01

Protective actions for hurricane threats are a function of the environmental and information context; individual and household characteristics, including cultural worldviews, past hurricane experiences, and risk perceptions; and motivations and barriers to actions. Using survey data from the Miami-Dade and Houston-Galveston areas, we regress individuals' stated evacuation intentions on these factors in two information conditions: (1) seeing a forecast that a hurricane will hit one's area, and (2) receiving an evacuation order. In both information conditions having an evacuation plan, wanting to keep one's family safe, and viewing one's home as vulnerable to wind damage predict increased evacuation intentions. Some predictors of evacuation intentions differ between locations; for example, Florida respondents with more egalitarian worldviews are more likely to evacuate under both information conditions, and Florida respondents with more individualist worldviews are less likely to evacuate under an evacuation order, but worldview was not significantly associated with evacuation intention for Texas respondents. Differences by information condition also emerge, including: (1) evacuation intentions decrease with age in the evacuation order condition but increase with age in the saw forecast condition, and (2) evacuation intention in the evacuation order condition increases among those who rely on public sources of information on hurricane threats, whereas in the saw forecast condition evacuation intention increases among those who rely on personal sources. Results reinforce the value of focusing hurricane information efforts on evacuation plans and residential vulnerability and suggest avenues for future research on how hurricane contexts shape decision making. © 2015 Society for Risk Analysis.

An extended cost potential field cellular automata model considering behavior variation of pedestrian flow

NASA Astrophysics Data System (ADS)

Guo, Fang; Li, Xingli; Kuang, Hua; Bai, Yang; Zhou, Huaguo

2016-11-01

The original cost potential field cellular automata describing normal pedestrian evacuation is extended to study more general evacuation scenarios. Based on the cost potential field function, through considering the psychological characteristics of crowd under emergencies, the quantitative formula of behavior variation is introduced to reflect behavioral changes caused by psychology tension. The numerical simulations are performed to investigate the effects of the magnitude of behavior variation, the different pedestrian proportions with different behavior variation and other factors on the evacuation efficiency and process in a room. The spatiotemporal dynamic characteristic during the evacuation process is also discussed. The results show that compared with the normal evacuation, the behavior variation under an emergency does not necessarily lead to the decrease of the evacuation efficiency. At low density, the increase of the behavior variation can improve the evacuation efficiency, while at high density, the evacuation efficiency drops significantly with the increasing amplitude of the behavior variation. In addition, the larger proportion of pedestrian affected by the behavior variation will prolong the evacuation time.

Community disruptions and business costs for distant tsunami evacuations using maximum versus scenario-based zones

USGS Publications Warehouse

Wood, Nathan J.; Wilson, Rick I.; Ratliff, Jamie L.; Peters, Jeff; MacMullan, Ed; Krebs, Tessa; Shoaf, Kimberley; Miller, Kevin

2017-01-01

Well-executed evacuations are key to minimizing loss of life from tsunamis, yet they also disrupt communities and business productivity in the process. Most coastal communities implement evacuations based on a previously delineated maximum-inundation zone that integrates zones from multiple tsunami sources. To support consistent evacuation planning that protects lives but attempts to minimize community disruptions, we explore the implications of scenario-based evacuation procedures and use the California (USA) coastline as our case study. We focus on the land in coastal communities that is in maximum-evacuation zones, but is not expected to be flooded by a tsunami generated by a Chilean earthquake scenario. Results suggest that a scenario-based evacuation could greatly reduce the number of residents and employees that would be advised to evacuate for 24–36 h (178,646 and 159,271 fewer individuals, respectively) and these reductions are concentrated primarily in three counties for this scenario. Private evacuation spending is estimated to be greater than public expenditures for operating shelters in the area of potential over-evacuations ($13 million compared to $1 million for a 1.5-day evacuation). Short-term disruption costs for businesses in the area of potential over-evacuation are approximately $122 million for a 1.5-day evacuation, with one-third of this cost associated with manufacturing, suggesting that some disruption costs may be recouped over time with increased short-term production. There are many businesses and organizations in this area that contain individuals with limited mobility or access and functional needs that may have substantial evacuation challenges. This study demonstrates and discusses the difficulties of tsunami-evacuation decision-making for relatively small to moderate events faced by emergency managers, not only in California but in coastal communities throughout the world.

Sigmoid irrigation tube for the management of chronic evacuation disorders.

PubMed

Gauderer, Michael W L; Decou, James M; Boyle, John T

2002-03-01

Antegrade colonic irrigation, in which the right colon is accessed via appendicostomy or cecostomy, now is an important adjunct in the management of children with chronic evacuation disorders. However, in most children, the major area of dysfunction is the left rather than the right colon. The authors developed a simple, percutaneous endoscopic, laparoscopically controlled sigmoid irrigation tube placement and evaluated the results in 4 children. A rigid sigmoidoscope is advanced into the upper sigmoid and the loop brought in contact with the abdominal wall under laparoscopic control. A small skin incision is made and a needle pushed across the abdominal and sigmoid walls into the lumen of the sigmoidoscope. A guide wire is advanced through the needle into the scope and retrieved. After the scope is removed, a PEG-type catheter is attached to the guide wire and pulled back, securing the sigmoid loop to the abdominal wall. The tube is subsequently converted to a skin-level device by simply adding an external port valve. All 4 patients achieved prompt evacuation in the sitting position. Sigmoid tube for antegrade irrigation is an appealing alternative to conventional cecal access. The procedure is simple and may offer physiologic advantages. Copyright 2002 by W.B. Saunders Company.

Effect of evacuation on liver function after the Fukushima Daiichi Nuclear Power Plant accident: The Fukushima Health Management Survey.

PubMed

Takahashi, Atsushi; Ohira, Tetsuya; Hosoya, Mitsuaki; Yasumura, Seiji; Nagai, Masato; Ohira, Hiromasa; Hashimoto, Shigeatsu; Satoh, Hiroaki; Sakai, Akira; Ohtsuru, Akira; Kawasaki, Yukihiko; Suzuki, Hitoshi; Kobashi, Gen; Ozasa, Kotaro; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi

2017-04-01

The Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident caused residents to switch from their normal lives to lives focused on evacuation. We evaluated liver function before and after this disaster to elucidate the effects of evacuation on liver function. This study was a longitudinal survey of 26,006 Japanese men and women living near the Fukushima Daiichi Nuclear Power Plant. This study was undertaken using data from annual health checkups conducted for persons aged 40-90 years between 2008 and 2010. Follow-up examinations were conducted from June 2011 to the end of March 2013, with a mean follow up of 1.6 years. Changes in liver function before and after the disaster were compared among evacuees and non-evacuees. We also assessed groups according to alcohol drinking status. The prevalence of liver dysfunction significantly increased in all participants from 16.4% before to 19.2% after the disaster. The incidence of liver dysfunction was significantly higher in evacuees than in non-evacuees. Multivariate logistic regression analysis showed that evacuation was significantly associated with liver dysfunction among residents. This is the first study to show that evacuation due to the Fukushima Daiichi nuclear power plant disaster was associated with an increase in liver dysfunction. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Proctographic features of anismus.

PubMed

Halligan, S; Bartram, C I; Park, H J; Kamm, M A

1995-12-01

To document the proctographic features of anismus at evacuation proctography and determine the optimum radiologic measurements for diagnosis. Twenty-four patients with anismus according to clinical and multiple physiologic criteria were examined with evacuation proctography. Structural and functional measurements were compared with those of a group of 20 asymptomatic subjects. No significant difference between patients and control subjects was found with respect to pelvic descent, rectocele, or any anorectal angle measurement. In patients with anismus, initiation of evacuation was prolonged (median, 9 vs 3 seconds for control subjects; P < .0001) and anal canal width was reduced (median, 0.6 vs 1.2 cm; P = .0075). Evacuation time was increased (median, 50 vs 10 seconds; P < .0001), and the percentage of contrast material evacuated was decreased (median, 60% vs 100%; P < .0001). Only four patients were able to evacuate more than 66% of the contrast material within 30 seconds, whereas all control subjects were able to do so. Measurement of the anorectal angle to diagnose anismus should be abandoned. Patients with anismus demonstrate delayed initiation of evacuation, which is also prolonged and incomplete. Incomplete evacuation after 30 seconds is highly suggestive of anismus.

People's Risk Recognition Preceding Evacuation and Its Role in Demand Modeling and Planning.

PubMed

Urata, Junji; Pel, Adam J

2018-05-01

Evacuation planning and management involves estimating the travel demand in the event that such action is required. This is usually done as a function of people's decision to evacuate, which we show is strongly linked to their risk awareness. We use an empirical data set, which shows tsunami evacuation behavior, to demonstrate that risk recognition is not synonymous with objective risk, but is instead determined by a combination of factors including risk education, information, and sociodemographics, and that it changes dynamically over time. Based on these findings, we formulate an ordered logit model to describe risk recognition combined with a latent class model to describe evacuation choices. Our proposed evacuation choice model along with a risk recognition class can evaluate quantitatively the influence of disaster mitigation measures, risk education, and risk information. The results obtained from the risk recognition model show that risk information has a greater impact in the sense that people recognize their high risk. The results of the evacuation choice model show that people who are unaware of their risk take a longer time to evacuate. © 2017 Society for Risk Analysis.

Urogenital consequences in ageing women.

PubMed

Doumouchtsis, Stergios K; Chrysanthopoulou, Eleftheria L

2013-10-01

Various anatomical, physiological, genetic, lifestyle and reproductive factors interact throughout a woman's life span and contribute to pelvic floor disorders. Ageing affects pelvic floor anatomy and function, which can result in a variety of disorders, such as pelvic organ prolapse, lower urinary tract symptoms, dysfunctional bowel and bladder evacuation, and sexual dysfunction. The exact mechanisms and pathophysiological processes by which ageing affects pelvic floor and lower urinary and gastrointestinal tract anatomy and function are not always clear. In most cases, it is difficult to ascertain the exact role of ageing per se as an aetiological, predisposing or contributing factor. Other conditions associated with ageing that may co-exist, such as changes in mental status, can result in different types of pelvic floor dysfunction (e.g. functional incontinence). Pelvic organ dysfunction may be associated with significant morbidity and affect quality of life. These groups of patients often pose difficult diagnostic and therapeutic dilemmas owing to complex medical conditions and concurrent morbidities. In this chapter, we summarise the current evidence on the management of pelvic floor disorders, with emphasis on elderly women and the associations between the ageing process and these disorders. Clinicians with an understanding of the affect of ageing on the pelvic floor and lower urinary and gastrointestinal tract anatomy and function, and the complex interplay of other comorbidities, will be able to investigate, diagnose and treat appropriately there women. A holistic approach may result in substantial improvements in their quality of life. Copyright © 2013. Published by Elsevier Ltd.

Reconsideration of Harm's Way: Onsets and Comorbidity Patterns of Disorders in Preschool Children and Their Caregivers Following Hurricane Katrina

ERIC Educational Resources Information Center

Scheeringa, Michael S.; Zeanah, Charles H.

2008-01-01

This study examined posttraumatic stress disorder (PTSD) and comorbid disorders in 70 preschool children (ages 3-6) and their caregivers following Hurricane Katrina. Children's rate of PTSD was 50.0% using age-modified criteria. The rate of PTSD was 62.5% for those who stayed in the city and 43.5% in those who evacuated. Of those with PTSD, 88.6%…

Evacuation of the ICU

PubMed Central

Niven, Alexander S.; Beninati, William; Fang, Ray; Einav, Sharon; Rubinson, Lewis; Kissoon, Niranjan; Devereaux, Asha V.; Christian, Michael D.; Grissom, Colin K.; Christian, Michael D.; Devereaux, Asha V.; Dichter, Jeffrey R.; Kissoon, Niranjan; Rubinson, Lewis; Amundson, Dennis; Anderson, Michael R.; Balk, Robert; Barfield, Wanda D.; Bartz, Martha; Benditt, Josh; Beninati, William; Berkowitz, Kenneth A.; Daugherty Biddison, Lee; Braner, Dana; Branson, Richard D; Burkle, Frederick M.; Cairns, Bruce A.; Carr, Brendan G.; Courtney, Brooke; DeDecker, Lisa D.; De Jong, Marla J.; Dominguez-Cherit, Guillermo; Dries, David; Einav, Sharon; Erstad, Brian L.; Etienne, Mill; Fagbuyi, Daniel B.; Fang, Ray; Feldman, Henry; Garzon, Hernando; Geiling, James; Gomersall, Charles D.; Grissom, Colin K.; Hanfling, Dan; Hick, John L.; Hodge, James G.; Hupert, Nathaniel; Ingbar, David; Kanter, Robert K.; King, Mary A.; Kuhnley, Robert N.; Lawler, James; Leung, Sharon; Levy, Deborah A.; Lim, Matthew L.; Livinski, Alicia; Luyckx, Valerie; Marcozzi, David; Medina, Justine; Miramontes, David A.; Mutter, Ryan; Niven, Alexander S.; Penn, Matthew S.; Pepe, Paul E.; Powell, Tia; Prezant, David; Reed, Mary Jane; Rich, Preston; Rodriquez, Dario; Roxland, Beth E.; Sarani, Babak; Shah, Umair A.; Skippen, Peter; Sprung, Charles L.; Subbarao, Italo; Talmor, Daniel; Toner, Eric S.; Tosh, Pritish K.; Upperman, Jeffrey S.; Uyeki, Timothy M.; Weireter, Leonard J.; West, T. Eoin; Wilgis, John; Ornelas, Joe; McBride, Deborah; Reid, David; Baez, Amado; Baldisseri, Marie; Blumenstock, James S.; Cooper, Art; Ellender, Tim; Helminiak, Clare; Jimenez, Edgar; Krug, Steve; Lamana, Joe; Masur, Henry; Mathivha, L. Rudo; Osterholm, Michael T.; Reynolds, H. Neal; Sandrock, Christian; Sprecher, Armand; Tillyard, Andrew; White, Douglas; Wise, Robert; Yeskey, Kevin

2014-01-01

BACKGROUND: Despite the high risk for patient harm during unanticipated ICU evacuations, critical care providers receive little to no training on how to perform safe and effective ICU evacuations. We reviewed the pertinent published literature and offer suggestions for the critical care provider regarding ICU evacuation. The suggestions in this article are important for all who are involved in pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS: The Evacuation and Mobilization topic panel used the American College of Chest Physicians (CHEST) Guidelines Oversight Committee’s methodology to develop seven key questions for which specific literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. RESULTS: Based on current best evidence, we provide 13 suggestions outlining a systematic approach to prepare for and execute an effective ICU evacuation during a disaster. Interhospital and intrahospital collaboration and functional ICU communication are critical for success. Pre-event planning and preparation are required for a no-notice evacuation. A Critical Care Team Leader must be designated within the Hospital Incident Command System. A three-stage ICU Evacuation Timeline, including (1) no immediate threat, (2) evacuation threat, and (3) evacuation implementation, should be used. Detailed suggestions on ICU evacuation, including regional planning, evacuation drills, patient transport preparation and equipment, patient prioritization and distribution for evacuation, patient information and tracking, and federal and international evacuation assistance systems, are also provided. CONCLUSIONS: Successful ICU evacuation during a disaster requires active preparation, participation, communication, and leadership by critical care providers. Critical care providers have a professional obligation to become better educated, prepared, and engaged with the processes of ICU evacuation to provide a safe continuum of critical care during a disaster. PMID:25144509

Evacuation of the ICU: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

King, Mary A; Niven, Alexander S; Beninati, William; Fang, Ray; Einav, Sharon; Rubinson, Lewis; Kissoon, Niranjan; Devereaux, Asha V; Christian, Michael D; Grissom, Colin K

2014-10-01

Despite the high risk for patient harm during unanticipated ICU evacuations, critical care providers receive little to no training on how to perform safe and effective ICU evacuations. We reviewed the pertinent published literature and offer suggestions for the critical care provider regarding ICU evacuation. The suggestions in this article are important for all who are involved in pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. The Evacuation and Mobilization topic panel used the American College of Chest Physicians (CHEST) Guidelines Oversight Committee's methodology to develop seven key questions for which specific literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. Based on current best evidence, we provide 13 suggestions outlining a systematic approach to prepare for and execute an effective ICU evacuation during a disaster. Interhospital and intrahospital collaboration and functional ICU communication are critical for success. Pre-event planning and preparation are required for a no-notice evacuation. A Critical Care Team Leader must be designated within the Hospital Incident Command System. A three-stage ICU Evacuation Timeline, including (1) no immediate threat, (2) evacuation threat, and (3) evacuation implementation, should be used. Detailed suggestions on ICU evacuation, including regional planning, evacuation drills, patient transport preparation and equipment, patient prioritization and distribution for evacuation, patient information and tracking, and federal and international evacuation assistance systems, are also provided. Successful ICU evacuation during a disaster requires active preparation, participation, communication, and leadership by critical care providers. Critical care providers have a professional obligation to become better educated, prepared, and engaged with the processes of ICU evacuation to provide a safe continuum of critical care during a disaster.

Effect of authority figures for pedestrian evacuation at metro stations

NASA Astrophysics Data System (ADS)

Song, Xiao; Zhang, Zenghui; Peng, Gongzhuang; Shi, Guoqiang

2017-01-01

Most pedestrian evacuation literatures are about routing algorithm, human intelligence and behavior etc. Few works studied how to fully explore the function of authority/security figures, who know more of the environment by simply being there every day. To evaluate the effect of authority figure (AF) in complex buildings, this paper fully investigates the AF related factors that may influence the evacuation effect of crowd, such as the number and locations of AFs, their spread of direction, calming effect and distribution strategies etc. Social force based modeling and simulation results show that these factors of AFs play important roles in evacuation efficiency, which means fewer AFs with right guiding strategy can have good evacuation performance. For our case study, Zhichun Avenue station, the conclusion is that deployment of four AFs is a good choice to achieve relatively high evacuation performance yet save cost.

Pedestrian evacuation modeling to reduce vehicle use for distant tsunami evacuations in Hawaiʻi

USGS Publications Warehouse

Wood, Nathan J.; Jones, Jamie; Peters, Jeff; Richards, Kevin

2018-01-01

Tsunami waves that arrive hours after generation elsewhere pose logistical challenges to emergency managers due to the perceived abundance of time and inclination of evacuees to use vehicles. We use coastal communities on the island of Oʻahu (Hawaiʻi, USA) to demonstrate regional evacuation modeling that can identify where successful pedestrian-based evacuations are plausible and where vehicle use could be discouraged. The island of Oʻahu has two tsunami-evacuation zones (standard and extreme), which provides the opportunity to examine if recommended travel modes vary based on zone. Geospatial path distance models are applied to estimate population exposure as a function of pedestrian travel time and speed out of evacuation zones. The use of the extreme zone triples the number of residents, employees, and facilities serving at-risk populations that would be encouraged to evacuate and slightly reduces the percentage of residents (98–76%) that could evacuate in less than 15 min at a plausible speed (with similar percentages for employees). Areas with lengthy evacuations are concentrated in the North Shore region for the standard zone but found all around the Oʻahu coastline for the extreme zone. The use of the extreme zone results in a 26% increase in the number of hotel visitors that would be encouraged to evacuate, and a 76% increase in the number of them that may require more than 15 min. Modeling can identify where pedestrian evacuations are plausible; however, there are logistical and behavioral issues that warrant attention before localized evacuation procedures may be realistic.

Normal values for high-resolution anorectal manometry in healthy women: effects of age and significance of rectoanal gradient.

PubMed

Noelting, Jessica; Ratuapli, Shiva K; Bharucha, Adil E; Harvey, Doris M; Ravi, Karthik; Zinsmeister, Alan R

2012-10-01

High-resolution manometry (HRM) is used to measure anal pressures in clinical practice but normal values have not been available. Although rectal evacuation is assessed by the rectoanal gradient during simulated evacuation, there is substantial overlap between healthy people and defecatory disorders, and the effects of age are unknown. We evaluated the effects of age on anorectal pressures and rectal balloon expulsion in healthy women. Anorectal pressures (HRM), rectal sensation, and balloon expulsion time (BET) were evaluated in 62 asymptomatic women ranging in age from 21 to 80 years (median age 44 years) without risk factors for anorectal trauma. In total, 30 women were aged <50 years. Age is associated with lower (r=-0.47, P<0.01) anal resting (63 (5) (≥50 years), 88 (3) (<50 years), mean (s.e.m.)) but not squeeze pressures; higher rectal pressure and rectoanal gradient during simulated evacuation (r=0.3, P<0.05); and a shorter (r=-0.4, P<0.01) rectal BET (17 (9) s (≥50 years) vs. 31 (10) s (<50 years)). Only 5 women had a prolonged (>60 s) rectal BET but 52 had higher anal than rectal pressures (i.e., negative gradient) during simulated evacuation. The gradient was more negative in younger (-41 (6) mm Hg) than older (-12 (6) mm Hg) women and negatively (r=-0.51, P<0.0001) correlated with rectal BET but only explained 16% of the variation in rectal BET. These observations provide normal values for anorectal pressures by HRM. Increasing age is associated with lower anal resting pressure, a more positive rectoanal gradient during simulated evacuation, and a shorter BET in asymptomatic women. Although the rectoanal gradient is negatively correlated with rectal BET, this gradient is negative even in a majority of asymptomatic women, undermining the utility of a negative gradient for diagnosing defecatory disorders by HRM.

Simulating the effects of social networks on a population's hurricane evacuation participation

NASA Astrophysics Data System (ADS)

Widener, Michael J.; Horner, Mark W.; Metcalf, Sara S.

2013-04-01

Scientists have noted that recent shifts in the earth's climate have resulted in more extreme weather events, like stronger hurricanes. Such powerful storms disrupt societal function and result in a tremendous number of casualties, as demonstrated by recent hurricane experience in the US Planning for and facilitating evacuations of populations forecast to be impacted by hurricanes is perhaps the most effective strategy for reducing risk. A potentially important yet relatively unexplored facet of people's evacuation decision-making involves the interpersonal communication processes that affect whether at-risk residents decide to evacuate. While previous research has suggested that word-of-mouth effects are limited, data supporting these assertions were collected prior to the widespread adoption of digital social media technologies. This paper argues that the influence of social network effects on evacuation decisions should be revisited given the potential of new social media for impacting and augmenting information dispersion through real-time interpersonal communication. Using geographic data within an agent-based model of hurricane evacuation in Bay County, Florida, we examine how various types of social networks influence participation in evacuation. It is found that strategies for encouraging evacuation should consider the social networks influencing individuals during extreme events, as it can be used to increase the number of evacuating residents.

An interval-parameter mixed integer multi-objective programming for environment-oriented evacuation management

NASA Astrophysics Data System (ADS)

Wu, C. Z.; Huang, G. H.; Yan, X. P.; Cai, Y. P.; Li, Y. P.

2010-05-01

Large crowds are increasingly common at political, social, economic, cultural and sports events in urban areas. This has led to attention on the management of evacuations under such situations. In this study, we optimise an approximation method for vehicle allocation and route planning in case of an evacuation. This method, based on an interval-parameter multi-objective optimisation model, has potential for use in a flexible decision support system for evacuation management. The modeling solutions are obtained by sequentially solving two sub-models corresponding to lower- and upper-bounds for the desired objective function value. The interval solutions are feasible and stable in the given decision space, and this may reduce the negative effects of uncertainty, thereby improving decision makers' estimates under different conditions. The resulting model can be used for a systematic analysis of the complex relationships among evacuation time, cost and environmental considerations. The results of a case study used to validate the proposed model show that the model does generate useful solutions for planning evacuation management and practices. Furthermore, these results are useful for evacuation planners, not only in making vehicle allocation decisions but also for providing insight into the tradeoffs among evacuation time, environmental considerations and economic objectives.

Exposure to the World Trade Center Disaster and 9/11-Related Post-Traumatic Stress Disorder and Household Disaster Preparedness.

PubMed

Gargano, Lisa M; Caramanica, Kimberly; Sisco, Sarah; Brackbill, Robert M; Stellman, Steven D

2015-12-01

In a population with prior exposure to the World Trade Center disaster, this study sought to determine the subsequent level of preparedness for a new disaster and how preparedness varied with population characteristics that are both disaster-related and non-disaster-related. The sample included 4496 World Trade Center Health Registry enrollees who completed the Wave 3 (2011-2012) and Hurricane Sandy (2013) surveys. Participants were considered prepared if they reported possessing at least 7 of 8 standard preparedness items. Logistic regression was used to determine associations between preparedness and demographic and medical factors, 9/11-related post-traumatic stress disorder (PTSD) assessed at Wave 3, 9/11 exposure, and social support. Over one-third (37.5%) of participants were prepared with 18.8% possessing all 8 items. The item most often missing was an evacuation plan (69.8%). Higher levels of social support were associated with being prepared. High levels of 9/11 exposure were associated with being prepared in both the PTSD and non-PTSD subgroups. Our findings indicate that prior 9/11 exposure favorably impacted Hurricane Sandy preparedness. Future preparedness messaging should target people with low social support networks. Communications should include information on evacuation zones and where to find information about how to evacuate.

Simulating large-scale pedestrian movement using CA and event driven model: Methodology and case study

NASA Astrophysics Data System (ADS)

Li, Jun; Fu, Siyao; He, Haibo; Jia, Hongfei; Li, Yanzhong; Guo, Yi

2015-11-01

Large-scale regional evacuation is an important part of national security emergency response plan. Large commercial shopping area, as the typical service system, its emergency evacuation is one of the hot research topics. A systematic methodology based on Cellular Automata with the Dynamic Floor Field and event driven model has been proposed, and the methodology has been examined within context of a case study involving the evacuation within a commercial shopping mall. Pedestrians walking is based on Cellular Automata and event driven model. In this paper, the event driven model is adopted to simulate the pedestrian movement patterns, the simulation process is divided into normal situation and emergency evacuation. The model is composed of four layers: environment layer, customer layer, clerk layer and trajectory layer. For the simulation of movement route of pedestrians, the model takes into account purchase intention of customers and density of pedestrians. Based on evacuation model of Cellular Automata with Dynamic Floor Field and event driven model, we can reflect behavior characteristics of customers and clerks at the situations of normal and emergency evacuation. The distribution of individual evacuation time as a function of initial positions and the dynamics of the evacuation process is studied. Our results indicate that the evacuation model using the combination of Cellular Automata with Dynamic Floor Field and event driven scheduling can be used to simulate the evacuation of pedestrian flows in indoor areas with complicated surroundings and to investigate the layout of shopping mall.

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

DTIC Science & Technology

2015-02-01

of Combat Casualties in a Swine Polytrauma PRINCIPAL INVESTIGATOR: Richard McCarron, PhD CONTRACTING ORGANIZATION: Henry M. Jackson Foundation for the...Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma 5a. CONTRACT NUMBER...of neurotrauma and polytrauma . We plan to investigate the effects of aero-medical evacuation on neurophysiology and lung function in swine models of

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

DTIC Science & Technology

2016-02-01

changes in ambient conditions such as cabin pressure and temperature could potentially have detrimental effects on the already vulnerable brain. There...during simulated long-range aero-medical evacuation has adverse effects on brain blood flow and tissue oxygenation , as well as lung function in swine...is a dearth of knowledge about the effects of long range aero-medical evacuation on injured organs, as well as an emerging published database

Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult.

PubMed

Mearin, Fermín; Ciriza, Constanza; Mínguez, Miguel; Rey, Enrique; Mascort, Juan José; Peña, Enrique; Cañones, Pedro; Júdez, Javier

2016-06-01

In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antidepressants, psychological therapy, acupuncture, enemas, sacral root neurostimulation, surgery) are discussed, and practical recommendations are made regarding each of them.

Perceived Safety at Work in the Wake of Terror: The Importance of Security Measures and Emergency Preparedness.

PubMed

Nissen, Alexander; Heir, Trond

2016-12-01

We aimed to explore how perceived safety after terrorism is connected to views on security measures and emergency preparedness in a workplace setting. Using a questionnaire-based, cross-sectional study of ministerial employees in Norway who were targeted in a terrorist attack in 2011 (n=3344), we investigated how employees' perceived safety at work 9 to 10 months after the attack was associated with their perceptions of whether security measures were sufficiently prioritized at work, whether there had been sufficient escape and evacuation training, and whether they were confident with evacuation procedures. We found strong evidence of increasing perceived safety at work the more employees believed security measures were sufficiently prioritized at work (partially confounded by post-traumatic stress disorder), and the better their knowledge of evacuation procedures (modified by gender and education). The present study suggests that employers may enhance perceived safety at work for terror-exposed employees by showing a commitment to security measures and by ensuring employees know evacuation procedures well. More research is needed to investigate causality patterns behind the associations found in this cross-sectional study. (Disaster Med Public Health Preparedness. 2016;10:805-811).

Preservation of the inferior mesenteric artery via laparoscopic sigmoid colectomy performed for diverticular disease: real benefit or technical challenge: a randomized controlled clinical trial.

PubMed

Masoni, Luigi; Mari, Francesco Saverio; Nigri, Giuseppe; Favi, Francesco; Gasparrini, Marcello; Dall'Oglio, Anna; Pindozzi, Fioralba; Pancaldi, Alessandra; Brescia, Antonio

2013-01-01

Defecatory disorders are very common complications after left hemicolectomy and anterior rectal resection. These disorders seem related primarily to colonic denervation after the resection. To evaluate the real benefits of inferior mesenteric artery (IMA) preservation via laparoscopic left hemicolectomy performed for diverticular disease in terms of reduced colonic denervation and improved postoperative intestinal functions, a randomized, single-blinded (patients) controlled clinical trial was conducted. From January 2004 to January 2010, patients with symptomatic diverticular disease and a surgical indication were enrolled in the study and randomly assigned to two treatment groups. The first group underwent laparoscopic left hemicolectomy, which preserved the IMA by sectioning the sigmoid arteries one by one near the colonic wall, In the second group, the IMA was sectioned immediately below the origin of left colic artery. Defecation disorders were assessed by anorectal manometry and by three questionnaires to evaluate constipation, incontinence, and quality of life 6 months after the intervention. A total of 107 patients were included in the study. The 54 patients with preserved IMA showed a statistically lower incidence of defecation disorders such as fragmented evacuations, alternating bowel function, constipation, and minor incontinence, as well as less lifestyle alteration than the 53 patients with the IMA sectioned just below the left colic artery. This study confirmed that preservation of the IMA should be recommended to reduce the incidence of defecatory disorders after left hemicolectomy for benign disease.

Constipation: Pathophysiology and Current Therapeutic Approaches.

PubMed

Sharma, Amol; Rao, Satish

2017-01-01

Chronic constipation is a common, persistent condition affecting many patients worldwide, presenting significant economic burden and resulting in substantial healthcare utilization. In addition to infrequent bowel movements, the definition of constipation includes excessive straining, a sense of incomplete evacuation, failed or lengthy attempts to defecate, use of digital manoeuvres for evacuation of stool, abdominal bloating, and hard consistency of stools. After excluding secondary causes of constipation, chronic idiopathic or primary constipation can be classified as functional defecation disorder, slow-transit constipation (STC), and constipation-predominant irritable bowel syndrome (IBS-C). These classifications are not mutually exclusive and significant overlap exists. Initial therapeutic approach to primary constipation, regardless of aetiology, consists of diet and lifestyle changes such as encouraging adequate fluid and fibre intake, regular exercise, and dietary modification. Laxatives are the mainstay of pharmacologic treatment for potential long-term therapy in patients who do not respond to lifestyle or dietary modification. After a failed empiric trial of laxatives, diagnostic testing is necessary to understand underlying anorectal and/or colonic pathophysiology. No single test provides a comprehensive assessment for primary constipation; therefore, multiple tests are used to provide complementary information to one another. Dyssynergic defecation, a functional defecation disorder, is an acquired behavioural disorder of defecation present in two-thirds of adult patients, where an inability to coordinate the abdominal, recto-anal, and pelvic floor muscles during attempted defecation exists. Biofeedback therapy is the mainstay treatment for dyssynergic defecation aimed at improving coordination of abdominal and anorectal muscles. A large percentage of patients with dyssynergic defecation also exhibit rectal hyposensitivity and may benefit from the addition of sensory retraining. Our understanding of the pathophysiology of STC is evolving. The advent of high-resolution colonic manometry allows for the improved identification of colonic motor patterns and may provide further insight into pathophysiological mechanisms. In a minority of cases of STC, identification of colonic neuropathy suggests a medically refractory condition, warranting consideration of colectomy. The pathophysiology of IBS-C is poorly understood with multiple etiological factors implicated. Pharmacological advances in the treatment of primary constipation have added therapeutic options to the armamentarium of this disorder. Drug development in the secretagogue, serotonergic prokinetic, and ileal bile acid transporter inhibition pathways has yielded current and future medical treatment options for primary chronic constipation.

Does colostomy irrigation affect functional outcomes and quality of life in persons with a colostomy?

PubMed

Kent, Dea J; Long, Mary Arnold; Bauer, Carole

2015-01-01

Colostomy irrigation may be used by patients with colostomies to regulate bowel evacuations by stimulating emptying of the colon at regularly scheduled times. This Evidence-Based Report Card reviews the effect of colostomy irrigation on frequency of bowel evacuation, flatus production, odor, and health-related quality of life. We systematically reviewed the literature for studies that evaluated health-related quality of life in persons aged 18 years or older with colostomies of the sigmoid or descending left colon. A professional librarian performed the literature search, which yielded 499 articles using the search terms "colostomy," "colostomies," "therapeutic irrigation," "irrigation," and "irrigator." Following title and abstract reviews, we identified and retrieved 4 studies that met inclusion criteria. Colostomy irrigation reduces the frequency of bowel evacuations when compared to spontaneous evacuation and containment using a pouching system. Regular irrigation is associated with reductions in pouch usage. This change in bowel evacuation function frequently results in absence of bowel evacuations for 24 hours or longer, enabling some to discontinue ongoing use of a pouching system. Subjects using CI report reductions in flatus and odors associated with presence of a colostomy. One study was identified that found persons using CI reported higher health-related quality of life than did those who managed their colostomies with spontaneous evacuation using the Digestive Disease Quality of Life-15, but no differences were found when health-related quality of life was measured using the more generic instrument, the Medical Outcomes Study: Short Form-36. Instruction on principles and techniques of colostomy irrigation should be considered when managing patients with a permanent, left-sided colostomy.

[Roles and functions of military flight nursing: aeromedical evacuation].

PubMed

Lee, Chun-Lan; Hsiao, Yun-Chien; Chen, Chao-Yen

2012-06-01

Evacuating the injured is an important part of disaster medicine. Aircraft provide timely access to distant and remote areas and, in an emergency, can evacuate sick or injured individuals in such areas quickly and safely for critical treatment elsewhere. Aeromedical evacuation (AE) comprises the two categories of fixed-wing ambulance service and helicopter emergency medical service (HEMS). Each aims to accomplish unique objectives. In Taiwan, the Second Taiwan Strait Crisis in 1958 established the unique role and functions of medical flight nursing. Significant knowledge and experience has been accumulated in the field since that time in such areas as the effects of high altitude environments on individuals and equipment; physiological, psychological, social and spiritual factors that affect the injured and / or response team members; and emergency care delivery techniques. All have been essential elements in the development and delivery of comprehensive medical flight nurse training. Medical flight nursing belongs in a special professional category, as nurses must master knowledge on general and special-case casualty evacuation procedures, relevant instruments and equipment, triage, in-flight medical care, and aircraft loading requirements related to transporting the sick and injured. The internationalization of medical care has opened the potential to expand medical flight nursing roles and functions into disaster nursing. Although military considerations continue to frame medical flight nursing training and preparation today, the authors feel that creating strategic alliances with disaster nursing specialists and organizations overseas is a future developmental direction for Taiwan's medical flight nursing sector worth formal consideration.

Functional Status after Blast-Plus-Impact Complex Concussive Traumatic Brain Injury in Evacuated United States Military Personnel

PubMed Central

MacDonald, Christine L.; Johnson, Ann M.; Nelson, Elliot C.; Werner, Nicole J.; Fang, Raymond; Flaherty, Stephen F.

2014-01-01

Abstract Fundamental questions remain unanswered about the longitudinal impact of blast-plus-impact complex traumatic brain injuries (TBI) from wars in Iraq and Afghanistan. This prospective, observational study investigated measures of clinical outcome in US military personnel evacuated to Landstuhl Regional Medical Center (LRMC) in Germany after such “blast-plus” concussive TBIs. Glasgow Outcome Scale-Extended assessments completed 6–12 months after injury indicated a moderate overall disability in 41/47 (87%) blast-plus TBI subjects and a substantial but smaller number (11/18, 61%, p=0.018) of demographically similar US military controls without TBI evacuated for other medical reasons. Cognitive function assessed with a neuropsychological test battery was not different between blast-plus TBI subjects and controls; performance of both groups was generally in the normal range. No subject was found to have focal neurological deficits. However, 29/47 (57%) of blast-plus subjects with TBI met all criteria for post-traumatic stress disorder (PTSD) versus 5/18 (28%) of controls (p=0.014). PTSD was highly associated with overall disability; 31/34 patients with PTSD versus 19/31 patients who did not meet full PTSD criteria had moderate to severe disability (p=0.0003). Symptoms of depression were also more severe in the TBI group (p=0.05), and highly correlated with PTSD severity (r=0.86, p<0.0001). Thus, in summary, high rates of PTSD and depression but not cognitive impairment or focal neurological deficits were observed 6–12 months after concussive blast-plus-impact complex TBI. Overall disability was substantially greater than typically reported in civilian non-blast concussive (“mild”) patients with TBI, even with polytrauma. The relationship between these clinical outcomes and specific blast-related aspects of brain injuries versus other combat-related factors remains unknown. PMID:24367929

[PTSD-positive screening and factors influencing the mental state in victims evacuated/ not evacuated from Wenchuan earthquake area within 1 month].

PubMed

Gao, Xueping; Luo, Xingwei

2009-06-01

To explore posttraumatic stress disorder (PTSD) positive screening and factors influencing the mental state in victims who were evacuated/were not evacuated from Wenchuan earthquake area within 1 month. The 3 groups included 235 victims who were not evacuated from Shifang territory (the incident scene, Group A), 44 victims who were evacuated to Second Xiangya Hospital (the wounded, Group B) and 36 relatives (the relatives, Group C). The mental state of all subjects was evaluated by Impact of Event Scale-Revised (IES-R) and other tools. (1) One month after the disaster, and the positive rate of PTSD screening in these survivors was 35.56%, the positive rate in women was significantly higher than that in men (chi(2)=16.27,P<0.001). The positive rate of PTSD screening in Group A, Group B and Group C was 39.15%, 31.82%, and 16.67%, respectively, with significant difference (chi(2)(mh)=5.243,P<0.05). Among the three groups which met the diagnosis criterion of PTSD symptoms, the scores for "numbness/avoidance symptom"and "excessive arousing symptom"in Group A were significantly higher than those in Group B and C (P<0.01). (2) The scores for "anxiety"and "depression"and "psychosomatic"symptoms in Group A and Group B were significantly higher than those in Group C (P<0.05). (3) Gender, place of residence and evacuating from the earthquake area or not were factors of PTSD symptoms. One month after the earthquake, the victims suffered psychologically. PTSD symptoms, anxiety and depression symptoms were their major mental problems, more attention to especially women victims. The protection factors include dispersing victims to the secure place as soon as possible, expanding and strengthening society support. Early psychological interventions will help victims to raise their psychological endurance and prevent PTSD effectively.

Rectocele--does the size matter?

PubMed

Carter, Dan; Gabel, Marc Beer

2012-07-01

Large rectoceles (>2 cm) are believed to be associated with difficulty in evacuation, constipation, rectal pain, and rectal bleeding. The aim of our study was to determine whether rectocele size is related to patient's symptoms or defecatory parameters. We conducted a retrospective study on data collected on patients referred to our clinic for the evaluation of evacuation disorders. All patients were questioned for constipation, fecal incontinence, and irritable bowel syndrome and were assessed with dynamic perineal ultrasonography and conventional anorectal manometry. Four hundred eighty-seven women were included in our study. Rectocele was diagnosed in 106 (22%) women, and rectocele diameter >2 cm in 93 (87%) women. Rectocele size was not significantly related to demographic data, parity, or patient's symptoms. The severity of the symptoms was not correlated to the size or to the position of the rectocele. The diagnosis of irritable bowel syndrome was neither related to the size of the rectocele. Rectocele location, occurrence of enterocele, and intussusception were not related to the size of the rectocele. Full evacuation of rectoceles was more common in small rectoceles (79% vs. 24%, p = 0.0001), and no evacuation was more common in large rectoceles (37% vs. 0, p = 0.01). Rectal hyposensitivity and anismus were not related to the size of the rectocele. In conclusion, only the evacuation of rectoceles was correlated to the size of the rectoceles, but had no clinical significance. Other clinical, anatomical factors were also not associated to the size of the rectoceles. Rectoceles' size alone may not be an indication for surgery.

Community variations in population exposure to near-field tsunami hazards as a function of pedestrian travel time to safety

USGS Publications Warehouse

Wood, Nathan J.; Schmidtlein, Mathew C.

2013-01-01

Efforts to characterize population exposure to near-field tsunami threats typically focus on quantifying the number and type of people in tsunami-hazard zones. To develop and prioritize effective risk-reduction strategies, emergency managers also need information on the potential for successful evacuations and how this evacuation potential varies among communities. To improve efforts to properly characterize and differentiate near-field tsunami threats among multiple communities, we assess community variations in population exposure to tsunamis as a function of pedestrian travel time to safety. We focus our efforts on the multiple coastal communities in Grays Harbor and Pacific Counties (State of Washington, USA), where a substantial resident and visitor population is threatened by near-field tsunamis related to a potential Cascadia subduction zone earthquake. Anisotropic, path-distance modeling is conducted to estimate travel times to safety and results are merged with various population data, including residents, employees, public venues, and dependent-care facilities. Results suggest that there is substantial variability among communities in the number of people that may have insufficient time to evacuate. Successful evacuations may be possible in some communities assuming slow-walking speeds, are plausible in others if travel speeds are increased, and are unlikely in another set of communities given the large distances and short time horizon. Emergency managers can use these results to prioritize the location and determine the most appropriate type of tsunami risk-reduction strategies, such as education and training in areas where evacuations are plausible and vertical-evacuation structures in areas where they are not.

Topological and behavioral disorder in collective motion

NASA Astrophysics Data System (ADS)

Quint, David

2014-03-01

A major underlying assumption in many studies on the collective motion of self-propelled agents has been that the environment is continuous, isotropic and ordered and agents are all identical. In the natural world there are many examples of disordered environments or heterogeneous swarms where collective motion can exist. Examples include bats that navigate natural caverns via echolocation, schools of fish that maneuver through dark and light areas, microbial colonies that move about in heterogeneous soil, quorum sensing bacteria, crowds of people that are evacuating a building and traffic flow in major cities. In general disorder can arise from two basic sources that inhibit/augment both movement and information flow, those that represent physical obstacles (i.e topological), (extrinsic), and those that arise from behavioral heterogeneties within the swarm itself (intrinsic). In either case, extrinsic or intrinsic, disorder can be quenched or dynamic in space or time or both. To understand the effect of the various forms of disorder that can be present in the environment of the agents, we study both discrete and continuous 2 d agent based models that utilize only local interactions and study the transition to the collectively moving state as a function of the amount of disorder or behavioral heterogeneities present in the environment. I will present our recent results and discuss the effect that disorder has on collective motion and the general physical mechanisms that swarms, either real or artificial, could utilize in order to overcome disorder in their environment.

Evacuation areas for transportation accidents involving propellant tank pressure bursts

NASA Technical Reports Server (NTRS)

Siewert, R. D.

1972-01-01

Evacuation areas are defined for those transportation accidents where volatile chemical propellant tanks are exposed to fire in the wreckage and eventually explode with consequent risks from fragments in surrounding populated areas. An evacuation area with a minimum radius of 600 m (2000 ft) is recommended to limit the statistical probability of fatality to one in 100 such accidents. The result was made possible by the derivation of a distribution function of distances reached by fragments from bursting chemical car tanks. Data concerning fragments was obtained from reports or tank car pressure bursts between 1958 and 1971.

Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial.

PubMed

Indrio, Flavia; Di Mauro, Antonio; Riezzo, Giuseppe; Civardi, Elisa; Intini, Cristina; Corvaglia, Luigi; Ballardini, Elisa; Bisceglia, Massimo; Cinquetti, Mauro; Brazzoduro, Emanuela; Del Vecchio, Antonio; Tafuri, Silvio; Francavilla, Ruggiero

2014-03-01

Infantile colic, gastroesophageal reflux, and constipation are the most common functional gastrointestinal disorders that lead to referral to a pediatrician during the first 6 months of life and are often responsible for hospitalization, feeding changes, use of drugs, parental anxiety, and loss of parental working days with relevant social consequences. To investigate whether oral supplementation with Lactobacillus reuteri DSM 17938 during the first 3 months of life can reduce the onset of colic, gastroesophageal reflux, and constipation in term newborns and thereby reduce the socioeconomic impact of these conditions. A prospective, multicenter, double-masked, placebo-controlled randomized clinical trial was performed on term newborns (age <1 week) born at 9 different neonatal units in Italy between September 1, 2010, and October 30, 2012. Parents were asked to record in a structured diary the number of episodes of regurgitation, duration of inconsolable crying (minutes per day), number of evacuations per day, number of visits to pediatricians, feeding changes, hospitalizations, visits to a pediatric emergency department for a perceived health emergency, pharmacologic interventions, and loss of parental working days. In total, 589 infants were randomly allocated to receive L reuteri DSM 17938 or placebo daily for 90 days. Prophylactic use of probiotic. Reduction of daily crying time, regurgitation, and constipation during the first 3 months of life. Cost-benefit analysis of the probiotic supplementation. At 3 months of age, the mean duration of crying time (38 vs 71 minutes; P < .01), the mean number of regurgitations per day (2.9 vs 4.6; P < .01), and the mean number of evacuations per day (4.2 vs 3.6; P < .01) for the L reuteri DSM 17938 and placebo groups, respectively, were significantly different. The use of L reuteri DSM 17938 resulted in an estimated mean savings per patient of €88 (US $118.71) for the family and an additional €104 (US $140.30) for the community. Prophylactic use of L reuteri DSM 17938 during the first 3 months of life reduced the onset of functional gastrointestinal disorders and reduced private and public costs for the management of this condition. clinicaltrials.gov Identifier: NCT01235884.

Effects of evacuation assistant’s leading behavior on the evacuation efficiency: Information transmission approach

NASA Astrophysics Data System (ADS)

Wang, Xiao-Lu; Guo, Wei; Zheng, Xiao-Ping

2015-07-01

Evacuation assistants are expected to spread the escape route information and lead evacuees toward the exit as quickly as possible. Their leading behavior influences the evacuees’ movement directly, which is confirmed to be a decisive factor of the evacuation efficiency. The transmission process of escape information and its function on the evacuees’ movement are accurately presented by the proposed extended dynamic communication field model. For evacuation assistants and evacuees, their sensitivity parameter of static floor field (SFF), , and , are fully discussed. The simulation results indicate that the appropriate is associated with the maximum of evacuees. The optimal combinations of and were found to reach the highest evacuation efficiency. There also exists an optimal value for evacuation assistants’ information transmission radius. Project supported by the National Basic Research Program of China (Grant No. 2011CB706900), the National Natural Science Foundation of China (Grant Nos. 71225007 and 71203006), the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (Grant No. 2012BAK13B06), the Humanities and Social Sciences Project of the Ministry of Education of China (Grant Nos. 10YJA630221 and 12YJCZH023), and the Beijing Philosophy and Social Sciences Planning Project of the Twelfth Five-Year Plan, China (Grant Nos. 12JGC090 and 12JGC098).

Esophagogastric separation and abdominal esophagostomy via jejunal interposition: a new operation for extreme forms of pathologic aerophagia.

PubMed

Fukuzawa, Hiroaki; Urushihara, Naoto; Fukumoto, Koji; Sugiyama, Akihide; Mitsunaga, Maki; Watanabe, Kentaro; Hasegawa, Shiro

2011-10-01

Pathologic aerophagia is sometimes seen in patients with neurologic disorders. It rarely causes massive bowel distention, ileus, and volvulus. Here, we report the use of esophagogastric separation and abdominal esophagostomy via jejunal interposition to prevent bowel distention caused by severe aerophagia in 2 patients with neurologic disorders in whom the usual nonoperative methods of management failed. In both cases, swallowed air was evacuated via the jejunostomy, eliminating bowel distention. This operation may be useful in patients with neurologic disorders associated with severe aerophagia. Copyright © 2011 Elsevier Inc. All rights reserved.

[Anterior seromyotomy of the body and the functional part of the stomach combined with posterior truncal vagotomy and ulcer excision in the surgical treatment of complicated stomach ulcer].

PubMed

Petrov, V I; Sytnik, A P; Gorbunov, V N; KOrenev, N N; Naumov, B A; Gordeev, S A

1990-07-01

Anterior seromyotomy of the body and fundus of the stomach was combined with posterior truncal vagotomy and excision of the ulcer in 23 patients with gastric ulcer complicated by bleeding or perforation. Seventeen patients had chronic ulcers of the body of the stomach (type I), 3 patients had concurrent ulcers (type II), and 3 more patients had acute ulcers of the body of the stomach. Operation was undertaken for active bleeding from the ulcer in 20 patients and for perforating ulcer in 3 patients. One patient died. Mild disorders of evacuation of an aqueous barium sulfate suspension from the stomach were noted in 4 patients.

Anismus in patients with normal and slow transit constipation.

PubMed

Miller, R; Duthie, G S; Bartolo, D C; Roe, A M; Locke-Edmunds, J; Mortensen, N J

1991-06-01

This study examined differences in anorectal function, with particular reference to anismus, which might explain why some patients with intractable constipation have slow and others have normal whole gut transit times. Twenty-four patients were studied; 13 with slow transit (all female, median age 32 years, range 16-52 years) and 11 with normal transit (eight women, three men, median age 37 years, range 21-60 years). Videoproctography with synchronous sphincteric electromyography and anorectal manometry was performed. There were no differences between the two groups, suggesting that slow transit constipation is not secondary to any abnormality in anorectal function and may therefore be a primary disorder of colonic motility. There was no correlation between electromyographic evidence of anismus (pelvic floor contraction on defaecation) and the ability of the patient to evacute the rectum or symptoms of obstructed defaecation. Electromyography findings alone can be misleading and should be related to proctographic evidence of incomplete rectal evacuation before functional anismus can be said to be present.

Continent cecostomy. An account of 30 patients.

PubMed

Kock, N G; Myrvold, H E; Philipson, B M; Svaninger, G; Ojerskog, B

1985-10-01

In this paper, an account is given of our experience with continent colostomy in man. In five patients, the end-sigmoidostomy was provided with an intussusception valve. Evacuation of the bowel by irrigation through a catheter was laborious and time-consuming and this method was abandoned. In another group of 30 patients, the cecum was isolated from the rest of the colon and its distal end was provided with an intussusception valve. Of the 30 patients, eight were later given continent ileostomies, two were converted to conventional sigmoidostomies, and one patient with fecal incontinence preferred to have intestinal continuity reestablished. Thus, 19 patients still have continent cecostomies and are satisfied with their function. When comparing the function of the continent cecostomy with that of the continent ileostomy, however, it is obvious that the ileostomy function is superior. The experience obtained with this group of patients has resulted in a widening of the indications for constructing a continent ileostomy, including selected patients with various anorectal disorders.

[Irritable bowel syndrome with constipation and functional constipation in adults: Treatment (Part 2 of 2)].

PubMed

Mearin, F; Ciriza, C; Mínguez, M; Rey, E; Mascort, J J; Peña, E; Cañones, P; Júdez, J

2017-03-01

In this Clinical practice guide we examine the diagnostic and therapeutic management of adult patients with constipation and abdominal discomfort, at the confluence of the spectrum of irritable bowel syndrome and functional constipation. Both fall within the framework of functional intestinal disorders and have major personal, health and social impact, altering the quality of life of the patients affected. The former is a subtype of irritable bowel syndrome in which constipation and altered bowel habit predominate, often along with recurring abdominal pain, bloating and abdominal distension. Constipation is characterised by infrequent or hard-to-pass bowel movements, often accompanied by straining during defecation or the sensation of incomplete evacuation. There is no underlying organic cause in the majority of cases; it being considered a functional bowel disorder. There are many clinical and pathophysiological similarities between the two conditions, the constipation responds in a similar way to commonly used drugs, the fundamental difference being the presence or absence of pain, but not in an "all or nothing" way. The severity of these disorders depends not only on the intensity of the intestinal symptoms but also on other biopsychosocial factors: association of gastrointestinal and extraintestinal symptoms, degree of involvement, forms of perception and behaviour. Functional bowel disorders are diagnosed using the Rome criteria. This Clinical practice guide adapts to the Rome IV criteria published at the end of May 2016. The first part (96, 97, 98) examined the conceptual and pathophysiological aspects, alarm criteria, diagnostic test and referral criteria between Primary Care and Gastroenterology. This second part reviews all the available treatment alternatives (exercise, fluid ingestion, diet with soluble fibre-rich foods, fibre supplements, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antdepressants, psychological treatment, acupuncture, enemas, sacral root neurostimulation and surgery), and practical recommendations are made for each. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

The Pedestrian Evacuation Analyst: geographic information systems software for modeling hazard evacuation potential

USGS Publications Warehouse

Jones, Jeanne M.; Ng, Peter; Wood, Nathan J.

2014-01-01

Recent disasters such as the 2011 Tohoku, Japan, earthquake and tsunami; the 2013 Colorado floods; and the 2014 Oso, Washington, mudslide have raised awareness of catastrophic, sudden-onset hazards that arrive within minutes of the events that trigger them, such as local earthquakes or landslides. Due to the limited amount of time between generation and arrival of sudden-onset hazards, evacuations are typically self-initiated, on foot, and across the landscape (Wood and Schmidtlein, 2012). Although evacuation to naturally occurring high ground may be feasible in some vulnerable communities, evacuation modeling has demonstrated that other communities may require vertical-evacuation structures within a hazard zone, such as berms or buildings, if at-risk individuals are to survive some types of sudden-onset hazards (Wood and Schmidtlein, 2013). Researchers use both static least-cost-distance (LCD) and dynamic agent-based models to assess the pedestrian evacuation potential of vulnerable communities. Although both types of models help to understand the evacuation landscape, LCD models provide a more general overview that is independent of population distributions, which may be difficult to quantify given the dynamic spatial and temporal nature of populations (Wood and Schmidtlein, 2012). Recent LCD efforts related to local tsunami threats have focused on an anisotropic (directionally dependent) path distance modeling approach that incorporates travel directionality, multiple travel speed assumptions, and cost surfaces that reflect variations in slope and land cover (Wood and Schmidtlein, 2012, 2013). The Pedestrian Evacuation Analyst software implements this anisotropic path-distance approach for pedestrian evacuation from sudden-onset hazards, with a particular focus at this time on local tsunami threats. The model estimates evacuation potential based on elevation, direction of movement, land cover, and travel speed and creates a map showing travel times to safety (a time map) throughout a hazard zone. Model results provide a general, static view of the evacuation landscape at different pedestrian travel speeds and can be used to identify areas outside the reach of naturally occurring high ground. In addition, data on the size and location of different populations within the hazard zone can be integrated with travel-time maps to create tables and graphs of at-risk population counts as a function of travel time to safety. As a decision-support tool, the Pedestrian Evacuation Analyst provides the capability to evaluate the effectiveness of various vertical-evacuation structures within a study area, both through time maps of the modeled travel-time landscape with a potential structure in place and through comparisons of population counts within reach of safety. The Pedestrian Evacuation Analyst is designed for use by researchers examining the pedestrian-evacuation potential of an at-risk community. In communities where modeled evacuation times exceed the event (for example, tsunami wave) arrival time, researchers can use the software with emergency managers to assess the area and population served by potential vertical-evacuation options. By automating and managing the modeling process, the software allows researchers to concentrate efforts on providing crucial and timely information on community vulnerability to sudden-onset hazards.

Case report: treatment of subdural hematoma in the emergency department utilizing the subdural evacuating port system.

PubMed

Asfora, Wilson T; Klapper, Hendrik B

2013-08-01

Patients with acute or chronic subdural hematomas may present with rapidly deteriorating neurological function and are at risk for irreversible brainstem injury. In such cases, rapid surgical intervention is required to evacuate the hematoma and reverse critically elevated intracranial pressure. A variety of surgical drainage methods are in existence, none of which are clearly superior to the others. This report presents the case of a 74-year-old woman who suffered an acute-on-chronic subdural hematoma which was evacuated in the emergency department utilizing the subdural evacuating port system (SEPS). The SEPS provides for a minimally invasive technique to drain subdural hematomas and is advantageous in that it can be performed at the bedside. The SEPS is relatively simple to use and may be especially useful to emergency department staff in outlying areas where there is a shortage of neurosurgical coverage.

EXPERIMENTAL STUDIES ON DIFFICULTY OF EVACUATION FROM UNDERGROUND SPACES UNDER INUNDATED SITUATIONS USING REAL SCALE MODELS

NASA Astrophysics Data System (ADS)

Baba, Yasuyuki; Ishigaki, Taisuke; Toda, Keiichi; Nakagawa, Hajime

Many urbanized cities in Japan are located in alluvial plains, and the vulnerability of urbanized areas to flood disaster is highlighted by flood attacks due to heavy rain fall or typhoons. Underground spaces located in the urbanized area are flood-prone areas, and the intrusion of flood watar into underground space inflicted severe damages on urban functions and infrastructures. In a similar way, low-lying areas like "bowl-shaped" depression and underpasses under highway and railroad bridges are also prone to floods. The underpasses are common sites of accidents of submerged vehicles, and severe damage including human damage occasionally occurs under flooding conditions. To reduce the damage due to inundation in underground space, needless to say, early evacuation is one of the most important countermeasures. This paper shows some experimental results of evacuation tests from underground spaces under inundated situations. The difficulities of the evacuation from underground space has been investigated by using real scale models (door, staircase and vehicle), and the limit for safety evacuation is discussed. From the results, it is found that water depth of 0.3 - 0.4m would be a critical situation for the evacuation from underground space through staircases and door and that 0.7 - 0.8m deep on the ground would be also a critical situation for safety evacuation though the doors of the vehicle. These criteria have some possibility to vary according to different inundated situations, and they are also influenced by the individual variation like the difference of physical strength. This means that these criteria requires cautious stance to use although they show a sort of an index of the limitation for saftty evacuation from underground space.

A Multi-Disciplinary Approach to Tsunami Disaster Prevention in Java, Indonesia

NASA Astrophysics Data System (ADS)

Horns, D. M.; Hall, S.; Harris, R. A.

2016-12-01

The island of Java in Indonesia is the most densely populated island on earth, and is situated within one of the most tectonically active regions on the planet. Deadly tsunamis struck Java in 1994 and 2006. We conducted an assessment of tsunami hazards on the south coast of Java using a team of geologists, public health professionals, and disaster education specialists. The social science component included tsunami awareness surveys, education in communities and schools, evacuation drills, and evaluation. We found that the evacuation routes were generally appropriate for the local hazard, and that most people were aware of the routes and knew how to use them. However, functional tsunami warning systems were lacking in most areas and knowledge of natural warning signs was incomplete. We found that while knowledge of when to evacuate improved after our educational lesson, some incorrect beliefs persisted (e.g. misconceptions about types of earthquakes able to generate tsunamis and how far inland tsunamis can reach). There was a general over-reliance on government to alert when evacuation is needed as well as reluctance on the part of local leaders to take initiative to sound tsunami alerts. Many people on earth who are at risk of tsunamis live in areas where the government lacks resources to maintain a functional tsunami warning system. The best hope for protecting those people is direct education working within the local cultural belief system. Further collaboration is needed with government agencies to design consistent and repeated messages challenging misperceptions about when to evacuate and to encourage individuals to take personal responsibility based on natural warning signs.

Pyogenic Pericarditis and Cardiac Tamponade Due to Streptococcus anginosus in a Combat Theater.

PubMed

Maves, Ryan C; Tripp, Michael S; Franzos, Tracy; Wallace, Scott C; Drinkwine, Benjamin J; Villines, Todd C

2017-01-01

Streptococcus anginosus group pericarditis is rare. A 24-year-old male soldier presented for care at a military clinic in Afghanistan with shock and cardiac tamponade requiring emergent pericardial drainage and aeromedical evacuation. We review the patient's case, the need for serial pericardial drainage, and the available literature on this disorder.

Psychological consequences of a firework factory disaster in a local community.

PubMed

Elklit, Ask

2007-08-01

This study assessed the prevalence of post-traumatic stress disorder (PTSD) and other psychological consequences of an explosion disaster in a residential area in Kolding, Denmark, in November 2004. A community sample of 516 evacuated adults and a control group of 119 residents situated near the disaster area, but not affected by the explosion were assessed 3 months after the disaster by standardized instruments. Of the evacuated sample, 13% met DSM-IV criteria for PTSD in contrast to 1% in the control group; 35% of the exposed sample and 7% of the control group were identified as 'probable cases' by the GHQ-30 (both p's < 0.0005). The study provides evidence of the negative impact of a technological disaster on mental health and the need of preventive interventions.

The evacuation of cairns hospitals due to severe tropical cyclone Yasi.

PubMed

Little, Mark; Stone, Theona; Stone, Richard; Burns, Jan; Reeves, Jim; Cullen, Paul; Humble, Ian; Finn, Emmeline; Aitken, Peter; Elcock, Mark; Gillard, Noel

2012-09-01

On February 2, 2011, Tropical Cyclone Yasi, the largest cyclone to cross the Australian coast and a system the size of Hurricane Katrina, threatened the city of Cairns. As a result, the Cairns Base Hospital (CBH) and Cairns Private Hospital (CPH) were both evacuated, the hospitals were closed, and an alternate emergency medical center was established in a sports stadium 15 km from the Cairns central business district. This article describes the events around the evacuation of 356 patients, staff, and relatives to Brisbane (approximately 1,700 km away by road), closure of the hospitals, and the provision of a temporary emergency medical center for 28 hours during the height of the cyclone. Our experience highlights the need for adequate and exercised hospital evacuation plans; the need for clear command and control with identified decision-makers; early decision-making on when to evacuate; having good communication systems with redundancy; ensuring that patients are adequately identified and tracked and have their medications and notes; ensuring adequate staff, medications, and oxygen for holding patients; and planning in detail the alternate medical facility safety and its role, function, and equipment. © 2012 by the Society for Academic Emergency Medicine.

[Estimation of volume of pleural fluid and its impact on spirometrical parameters].

PubMed

Karwat, Krzysztof; Przybyłowski, Tadeusz; Bielicki, Piotr; Hildebrand, Katarzyna; Nowacka-Mazurek, Magdalena; Nasiłowski, Jacek; Rubinsztajn, Renata; Chazan, Ryszarda

2014-03-01

In the course of various diseases, there is an accumulation of fluid in the pleural cavities. Pleural fluid accumulation causes thoracic volume expansion and reduction of volume lungs, leading to formation of restrictive disorders. The aim of the study was to estimate the volume of pleural fluid by ultrasonography and to search for the relationship between pleural fluid volume and spirometrical parameters. The study involved 46 patients (26 men, 20 women) aged 65.7 +/- 14 years with pleural effusions who underwent thoracentesis. Thoracentesis was preceded by ultrasonography of the pleura, spirometry test and plethysmography. The volume of the pleural fluid was calculated with the Goecke' and Schwerk' (GS) or Padykuła (P) equations. The obtained values were compared with the actual evacuated volume. The median volume of the removed pleural fluid was 950 ml. Both underestimated the evacuated volume (the median volume 539 ml for GS and 648 ml for P, respectively). Pleural fluid removal resulted in a statistically significant improvement in VC (increase 0.20 +/- 0.35 ; p < 0.05), FEV1 (increase 0.16 +/- 0.32 l; p < 0.05), TLC (increase 0.30 +/- 0.58 l; p < 0.05) and PEF (0.37 +/- 1 l/s; p < 0.05) CONCLUSIONS: Pleural fluid removal causes a significant improvement in lung function parameters. The analyzed equations for fluid volume calculation do not correlate with the actual volume.

[Emergency and disaster response in critical care unit in the Mexican Social Security Institute: triage and evacuation].

PubMed

Echevarría-Zuno, Santiago; Cruz-Vega, Felipe; Elizondo-Argueta, Sandra; Martínez Valdés, Everardo; Franco-Bey, Rubén; Méndez-Sánchez, Luis Miguel

2013-01-01

Providing medical assistance in emergencies and disaster in advance makes the need to maintain Medical Units functional despite the disturbing phenomenon that confronts the community, but conflict occurs when the Medical Unit needs support and needs to be evacuated, especially when the evacuation of patients in a Critical Care Unit is required. In world literature there is little on this topic, and what is there usually focuses on the conversion of areas and increased ability to care for mass casualties, but not about how to evacuate if necessary, and when a wrong decision can have fatal consequences. That is why the Mexican Social Security Institute gave the task of examining these problems to a working group composed of specialists of the Institute. The purpose was to evaluate and establish a method for performing a protocol in the removal of patients and considering always to safeguard both staff and patients and maintain the quality of care.

Pedestrians’ behavior in emergency evacuation: Modeling and simulation

NASA Astrophysics Data System (ADS)

Wang, Lei; Zheng, Jie-Hui; Zhang, Xiao-Shuang; Zhang, Jian-Lin; Wang, Qiu-Zhen; Zhang, Qian

2016-11-01

The social force model has been widely used to simulate pedestrian evacuation by analyzing attractive, repulsive, driving, and fluctuating forces among pedestrians. Many researchers have improved its limitations in simulating behaviors of large-scale population. This study modifies the well-accepted social force model by considering the impacts of interaction among companions and further develops a comprehensive model by combining that with a multi-exit utility function. Then numerical simulations of evacuations based on the comprehensive model are implemented in the waiting hall of the Wulin Square Subway Station in Hangzhou, China. The results provide safety thresholds of pedestrian density and panic levels in different operation situations. In spite of the operation situation and the panic level, a larger friend-group size results in lower evacuation efficiency. Our study makes important contributions to building a comprehensive multi-exit social force model and to applying it to actual scenarios, which produces data to facilitate decision making in contingency plans and emergency treatment. Project supported by the National Natural Science Foundation of China (Grant No. 71471163).

Citizen Evacuation in Response to Nuclear and Nonnuclear Threats

DTIC Science & Technology

1981-09-01

upon one generic function, evacuation, and makes comparisons among two natural disasters and one nuclear disaster . An important goal of this work is to...probability that a wider geographic area will be involved, a nuclear [ disaster ] would not create essentially different problems for community response...people’s "prior experience" with nuclear disasters to help them arrive at a definition of threat associated with a given nuclear disaster . Indeed, the

Constipation is more frequent than diarrhea in patients fed exclusively by enteral nutrition: results of an observational study.

PubMed

Bittencourt, Amanda F; Martins, Juliana R; Logullo, Luciana; Shiroma, Glaucia; Horie, Lilian; Ortolani, Maria Claudia; Silva, Maria de Lourdes T; Waitzberg, Dan L

2012-08-01

Digestive complications in enteral nutrition (EN) can negatively affect the nutrition clinical outcome of hospitalized patients. Diarrhea and constipation are intestinal motility disorders associated with pharmacotherapy, hydration, nutrition status, and age. The aim of this study was to analyze the frequency of these intestinal motility disorders in patients receiving EN and assess risk factors associated with diarrhea and constipation in hospitalized patients receiving exclusive EN therapy in a general hospital. The authors performed a sequential and observational study of 110 hospitalized adult patients fed exclusively by EN through a feeding tube. Patients were categorized according to the type of intestinal transit disorder as follows: group D (diarrhea, 3 or more watery evacuations in 24 hours), group C (constipation, less than 1 evacuation during 3 days), and group N (absence of diarrhea or constipation). All prescription drugs were recorded, and patients were analyzed according to the type and amount of medication received. The authors also investigated the presence of fiber in the enteral formula. Patients classified in group C represented 70% of the study population; group D comprised 13%, and group N represented 17%. There was an association between group C and orotracheal intubation as the indication for EN (P < .001). Enteral formula without fiber was associated with constipation (logistic regression analysis: P < .001). Constipation is more frequent than diarrhea in patients fed exclusively by EN. Enteral diet with fiber may protect against medication-associated intestinal motility disorders. The addition of prokinetic drugs seems to be useful in preventing constipation.

Two Fixed, Evacuated, Glass, Solar Collectors Using Nonimaging Concentration

NASA Astrophysics Data System (ADS)

Garrison, John D.; Winston, Roland; O'Gallagher, Joseph; Ford, Gary

1984-01-01

Two fixed, evacuated, glass solar thermal collectors have been designed. The incorporation of nonimaging concentration, selective absorption and vacuum insulation into their design is essential for obtaining high efficiency through low heat loss, while operating at high temperatures. Nonimaging, approximately ideal concentration with wide acceptance angle permits solar radiation collection without tracking the sun, and insures collection of much of the diffuse radiation. It also minimizes the area of the absorbing surface, thereby reducing the radiation heat loss. Functional integration, where different parts of these two collectors serve more than one function, is also important in achieving high efficiency, and it reduces cost.

Pyogenic Pericarditis and Cardiac Tamponade Due to Streptococcus anginosus in a Combat Theater

PubMed Central

Tripp, Michael S.; Franzos, Tracy; Wallace, Scott C.; Drinkwine, Benjamin J.; Villines, Todd C.

2017-01-01

Abstract Streptococcus anginosus group pericarditis is rare. A 24-year-old male soldier presented for care at a military clinic in Afghanistan with shock and cardiac tamponade requiring emergent pericardial drainage and aeromedical evacuation. We review the patient’s case, the need for serial pericardial drainage, and the available literature on this disorder. PMID:28470013

Swallowing difficulties for cerebellar stroke may recover beyond three years.

PubMed

Périé, S; Wajeman, S; Vivant, R; St Guily, J L

1999-01-01

Swallowing disorders after stroke or skull base surgery can be life threatening. Although late recovery can occur, it remains poorly documented. We report a case of a 54-year-old woman with dysphagia resulting from a cerebellar stroke with hemorrhage that was evacuated through craniotomy. Swallowing difficulties were assessed by a videoendoscopic swallowing study. She presented with disruption of swallow initiation and impairment of the pharyngeal stage, resulting in hypopharyngeal stasis and penetration with aspiration. Supportive swallowing therapy was conducted with careful reeducation to assist initiation of the pharyngeal stage as well as development of compensatory postural technique. Initial improvement was very slow but became rapidly progressive from the 31st month after the stroke. By the 34th month, oral feeding was possible without aspiration. This case demonstrates that improvement in swallowing function can be expected even 3 years after stroke or skull base surgery. Determination of predictive factors for late functional recovery is of great importance and should be the focus of further investigation.

Tsunami evacuation mathematical model for the city of Padang

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kusdiantara, R.; Hadianti, R.; Badri Kusuma, M. S.

2012-05-22

Tsunami is a series of wave trains which travels with high speed on the sea surface. This traveling wave is caused by the displacement of a large volume of water after the occurrence of an underwater earthquake or volcano eruptions. The speed of tsunami decreases when it reaches the sea shore along with the increase of its amplitudes. Two large tsunamis had occurred in the last decades in Indonesia with huge casualties and large damages. Indonesian Tsunami Early Warning System has been installed along the west coast of Sumatra. This early warning system will give about 10-15 minutes to evacuatemore » people from high risk regions to the safe areas. Here in this paper, a mathematical model for Tsunami evacuation is presented with the city of Padang as a study case. In the model, the safe areas are chosen from the existing and selected high rise buildings, low risk region with relatively high altitude and (proposed to be built) a flyover ring road. Each gathering points are located in the radius of approximately 1 km from the ring road. The model is formulated as an optimization problem with the total normalized evacuation time as the objective function. The constraints consist of maximum allowable evacuation time in each route, maximum capacity of each safe area, and the number of people to be evacuated. The optimization problem is solved numerically using linear programming method with Matlab. Numerical results are shown for various evacuation scenarios for the city of Padang.« less

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

DTIC Science & Technology

2017-02-01

ambient conditions such as cabin pressure and temperature could potentially have detrimental effects on the already vulnerable brain. There is evidence...long-range aero-medical evacuation has adverse effects on brain blood flow and tissue oxygenation , as well as lung function in swine models of...differences in partial pressure of arterial oxygen or oxygen delivery, extraction and consumption data. This suggests that in this particular model

Modeling pedestrian evacuation by means of game theory

NASA Astrophysics Data System (ADS)

Shi, Dongmei; Zhang, Wenyao; Wang, Binghong

2017-04-01

Pedestrian evacuation is studied based on a modified lattice model. The payoff matrix in this model represents the complicated interactions between selfish individuals, and the mean force imposed on an individual is given by considering the impacts of neighbors, walls, and defector herding. Each passer-by moves to his selected location according to the Fermi function, and the average velocity of pedestrian flow is defined as a function of the motion rule. Two pedestrian types are included: cooperators, who adhere to the evacuation instructions; and defectors, who ignore the rules and act individually. It is observed that the escape time increases as fear degree increases, and the system remains smooth for a low fear degree, but exhibits three stages for a high fear degree. We prove that the fear degree determines the dynamics of this system, and the initial density of cooperators has a negligible impact. The system experiences three phases, a single phase of cooperator, a mixed two-phase pedestrian, and a single phase of defector sequentially as the fear degree upgrades. The phase transition has been proven basically robust to the changes of empty site contribution, wall’s pressure, and noise amplitude in the motion rule. It is further shown that pedestrians derive the greatest benefit from overall cooperation, but are trapped in the worst situation if they are all defectors. Dynamics of pedestrian evacuation.

Hurricane Sandy Evacuation Among World Trade Center Health Registry Enrollees in New York City.

PubMed

Brown, Shakara; Gargano, Lisa M; Parton, Hilary; Caramanica, Kimberly; Farfel, Mark R; Stellman, Steven D; Brackbill, Robert M

2016-06-01

Timely evacuation is vital for reducing adverse outcomes during disasters. This study examined factors associated with evacuation and evacuation timing during Hurricane Sandy among World Trade Center Health Registry (Registry) enrollees. The study sample included 1162 adults who resided in New York City's evacuation zone A during Hurricane Sandy who completed the Registry's Hurricane Sandy substudy in 2013. Factors assessed included zone awareness, prior evacuation experience, community cohesion, emergency preparedness, and poor physical health. Prevalence estimates and multiple logistic regression models of evacuation at any time and evacuation before Hurricane Sandy were created. Among respondents who evacuated for Hurricane Sandy (51%), 24% had evacuated before the storm. In adjusted analyses, those more likely to evacuate knew they resided in an evacuation zone, had evacuated during Hurricane Irene, or reported pre-Sandy community cohesion. Evacuation was less likely among those who reported being prepared for an emergency. For evacuation timing, evacuation before Hurricane Sandy was less likely among those with pets and those who reported 14 or more poor physical health days. Higher evacuation rates were observed for respondents seemingly more informed and who lived in neighborhoods with greater social capital. Improved disaster messaging that amplifies these factors may increase adherence with evacuation warnings. (Disaster Med Public Health Preparedness. 2016;10:411-419).

Pros and Cons While Looking Through an Asian Window on the Rome IV Criteria for Irritable Bowel Syndrome: Pros.

PubMed

Ghoshal, Uday C

2017-07-30

A decade after Rome III, in 2016, Rome IV criteria were published. There are major differences between Rome IV and the earlier iteration, some of which are in line with Asian viewpoints. The clinical applicability of the Rome IV criteria of irritable bowel syndrome (IBS) in Asian perspective is reviewed here. Instead of considering functional gastrointestinal disorders (FGIDs) to be largely psychogenic, Rome IV suggested the importance of the gut over brain ("disorders of gut-brain interaction" not "brain-gut interaction"). The word "functional" is underplayed. Multi-dimensional clinical profile attempts to recognize micro-organic nature, like slow colon transit and fecal evacuation disorders in constipation and dietary intolerance including that of lactose and fructose, bile acid malabsorption, non-celiac wheat sensitivity, small intestinal bacterial overgrowth, and gastrointestinal infection in diarrhea. Overlap between different FGIDs has been recognized as Rome IV suggests these to be a spectrum rather than discrete disorders. Bloating, common in Asia, received attention, though less. Sub-typing of IBS may be more clinician-friendly now as the patient-reported stool form may be used than a diary. However, a few issues, peculiar to Asia, need consideration; Rome IV, like Rome III, suggests that Bristol type I-II stool to denote constipation though Asian experts include type III as well. Work-up for physiological factors should be given greater importance. Language issue is important. Bloating, common in IBS, should be listed in the criteria. Threshold values for symptoms in Rome IV criteria are based on Western data. Post-infectious malabsorption (tropical sprue) should be excluded to diagnose post-infectious IBS, particularly in Asia.

[Irritable bowel syndrome with constipation and functional constipation in adults: Treatment (Part 2 of 2)].

PubMed

Mearin, F; Ciriza, C; Mínguez, M; Rey, E; Mascort, J J; Peña, E; Cañones, P; Júdez, J

2017-03-01

In this Clinical practice guide we examine the diagnostic and therapeutic management of adult patients with constipation and abdominal discomfort, at the confluence of the spectrum of irritable bowel syndrome and functional constipation. Both fall within the framework of functional intestinal disorders and have major personal, health and social impact, altering the quality of life of the patients affected. The former is a subtype of irritable bowel syndrome in which constipation and altered bowel habit predominate, often along with recurring abdominal pain, bloating and abdominal distension. Constipation is characterised by infrequent or hard-to-pass bowel movements, often accompanied by straining during defecation or the sensation of incomplete evacuation. There is no underlying organic cause in the majority of cases; it being considered a functional bowel disorder. There are many clinical and pathophysiological similarities between the two conditions, the constipation responds in a similar way to commonly used drugs, the fundamental difference being the presence or absence of pain, but not in an "all or nothing" way. The severity of these disorders depends not only on the intensity of the intestinal symptoms but also on other biopsychosocial factors: association of gastrointestinal and extraintestinal symptoms, degree of involvement, forms of perception and behaviour. Functional bowel disorders are diagnosed using the Rome criteria. This Clinical practice guide adapts to the Rome IV criteria published at the end of May 2016. The first part (96, 97, 98) examined the conceptual and pathophysiological aspects, alarm criteria, diagnostic test and referral criteria between Primary Care and Gastroenterology. This second part reviews all the available treatment alternatives (exercise, fluid ingestion, diet with soluble fibre-rich foods, fibre supplements, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antdepressants, psychological treatment, acupuncture, enemas, sacral root neurostimulation and surgery), and practical recommendations are made for each. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS

DTIC Science & Technology

2016-10-01

devastating injuries. Aeromedical evacuation of patients with Acute Respiratory Distress Syndrome (ARDS) is sometimes beyond the possibilities because of...sheep induces lung injury equivalent to a moderated ARDS. In a second group of studies sheep in which respiratory support was providing by a low flow...low pressure ECMO (ALung) partially rescued the animals returned the parameters of respiratory function to normal values. It is our goal to now use

Deployment Related Risk of Incident Mental Health Conditions Among Aeromedical Evacuation Crewmembers

DTIC Science & Technology

2015-09-01

PHA Physical Health Assessment PTSD Post-Traumatic Stress Disorder USAF United States Air Force xvi THIS PAGE INTENTIONALLY LEFT BLANK xvii...the Egyptian, Roman, and Greek empires, Soldiers have recounted stories of fellow Soldiers exhibiting physical and psychological symptoms after...again during a time of peace (American Psychological Association, 2013). The definition was broadened further to include the 12 threat of physical harm

Intra-community implications of implementing multiple tsunami-evacuation zones in Alameda, California

USGS Publications Warehouse

Peters, Jeff; Wood, Nathan J.; Wilson, Rick; Miller, Kevin

2016-01-01

Tsunami-evacuation planning in coastal communities is typically based on maximum evacuation zones for a single scenario or a composite of sources; however, this approach may over-evacuate a community and overly disrupt the local economy and strain emergency-service resources. To minimize the potential for future over-evacuations, multiple evacuation zones based on arrival time and inundation extent are being developed for California coastal communities. We use the coastal city of Alameda, California (USA), as a case study to explore population and evacuation implications associated with multiple tsunami-evacuation zones. We use geospatial analyses to estimate the number and type of people in each tsunami-evacuation zone and anisotropic pedestrian evacuation models to estimate pedestrian travel time out of each zone. Results demonstrate that there are tens of thousands of individuals in tsunami-evacuation zones on the two main islands of Alameda, but they will likely have sufficient time to evacuate before wave arrival. Quality of life could be impacted by the high number of government offices, schools, day-care centers, and medical offices in certain evacuation zones and by potentially high population density at one identified safe area after an evacuation. Multi-jurisdictional evacuation planning may be warranted, given that many at-risk individuals may need to evacuate to neighboring jurisdictions. The use of maximum evacuation zones for local tsunami sources may be warranted given the limited amount of available time to confidently recommend smaller zones which would result in fewer evacuees; however, this approach may also result in over-evacuation and the incorrect perception that successful evacuations are unlikely.

Numerical Simulation of Evacuation Process in Malaysia By Using Distinct-Element-Method Based Multi-Agent Model

NASA Astrophysics Data System (ADS)

Abustan, M. S.; Rahman, N. A.; Gotoh, H.; Harada, E.; Talib, S. H. A.

2016-07-01

In Malaysia, not many researches on crowd evacuation simulation had been reported. Hence, the development of numerical crowd evacuation process by taking into account people behavioral patterns and psychological characteristics is crucial in Malaysia. On the other hand, tsunami disaster began to gain attention of Malaysian citizens after the 2004 Indian Ocean Tsunami that need quick evacuation process. In relation to the above circumstances, we have conducted simulations of tsunami evacuation process at the Miami Beach of Penang Island by using Distinct Element Method (DEM)-based crowd behavior simulator. The main objectives are to investigate and reproduce current conditions of evacuation process at the said locations under different hypothetical scenarios for the efficiency study of the evacuation. The sim-1 is initial condition of evacuation planning while sim-2 as improvement of evacuation planning by adding new evacuation area. From the simulation result, sim-2 have a shorter time of evacuation process compared to the sim-1. The evacuation time recuded 53 second. The effect of the additional evacuation place is confirmed from decreasing of the evacuation completion time. Simultaneously, the numerical simulation may be promoted as an effective tool in studying crowd evacuation process.

Semi-automated vectorial analysis of anorectal motion by magnetic resonance defecography in healthy subjects and fecal incontinence.

PubMed

Noelting, J; Bharucha, A E; Lake, D S; Manduca, A; Fletcher, J G; Riederer, S J; Joseph Melton, L; Zinsmeister, A R

2012-10-01

Inter-observer variability limits the reproducibility of pelvic floor motion measured by magnetic resonance imaging (MRI). Our aim was to develop a semi-automated program measuring pelvic floor motion in a reproducible and refined manner. Pelvic floor anatomy and motion during voluntary contraction (squeeze) and rectal evacuation were assessed by MRI in 64 women with fecal incontinence (FI) and 64 age-matched controls. A radiologist measured anorectal angles and anorectal junction motion. A semi-automated program did the same and also dissected anorectal motion into perpendicular vectors representing the puborectalis and other pelvic floor muscles, assessed the pubococcygeal angle, and evaluated pelvic rotation. Manual and semi-automated measurements of anorectal junction motion (r = 0.70; P < 0.0001) during squeeze and evacuation were correlated, as were anorectal angles at rest, squeeze, and evacuation; angle change during squeeze or evacuation was less so. Semi-automated measurements of anorectal and pelvic bony motion were also reproducible within subjects. During squeeze, puborectalis injury was associated (P ≤ 0.01) with smaller puborectalis but not pelvic floor motion vectors, reflecting impaired puborectalis function. The pubococcygeal angle, reflecting posterior pelvic floor motion, was smaller during squeeze and larger during evacuation. However, pubococcygeal angles and pelvic rotation during squeeze and evacuation did not differ significantly between FI and controls. This semi-automated program provides a reproducible, efficient, and refined analysis of pelvic floor motion by MRI. Puborectalis injury is independently associated with impaired motion of puborectalis, not other pelvic floor muscles in controls and women with FI. © 2012 Blackwell Publishing Ltd.

Effectiveness of standing frame on constipation in children with cerebral palsy: a single-subject study.

PubMed

Rivi, Elena; Filippi, Mariacristina; Fornasari, Elisa; Mascia, Maria Teresa; Ferrari, Adriano; Costi, Stefania

2014-09-01

Children with cerebral palsy (CP) and quadriplegia or severe diplegia suffer from highly reduced mobility and consequent constipation. Clinicians recommend standing frames to exercise the support reaction in this population, sharing the opinion that the upright position may facilitate intestinal transit, although no evidence supports this assumption. We conducted this study to determine the effects of the standing frame on spontaneous evacuation in children with CP. Moreover, we studied its effects on the frequency of induction of evacuation, the characteristics of the stool and the pain suffered by the child due to constipation and/or evacuation. We implemented a single-subject research design in one chronically constipated child with CP and quadriplegia, Gross Motor Function Classification System Level V. To monitor the effects of the standing frame, we measured the outcome of interest throughout the study using a daily diary and the Bristol Stool Scale. This study was approved by the local Ethics Committee. This study has several limitation; primarily, the use of a single-subject research design only makes possible the visual analysis of data obtained from a unique patient. So, by themselves, data obtained do not allow us any generalization for the target population. Future research should verify our results collecting more data and also investigating the effect of the standing-frame on respiratory functions. Although the standing frame did not affect the frequency of evacuations or the characteristics of the stool, its employment reduced the inductions of evacuation and the related pain suffered by the child. However, this study has several limitations, such as the lack of generalization due to the fact that we studied a unique patient and the overall brevity of the study due to external circumstances. Therefore, we suggest future research to verify our results, also investigating the effect of the standing frame on respiratory functions. Relevance to clinical practice. The standing frame may positively influence the management of constipation of these children, possibly improving their quality of life. Copyright © 2014 John Wiley & Sons, Ltd.

Stakeholder-driven geospatial modeling for assessing tsunami vertical-evacuation strategies in the U.S. Pacific Northwest

NASA Astrophysics Data System (ADS)

Wood, N. J.; Schmidtlein, M.; Schelling, J.; Jones, J.; Ng, P.

2012-12-01

Recent tsunami disasters, such as the 2010 Chilean and 2011 Tohoku events, demonstrate the significant life loss that can occur from tsunamis. Many coastal communities in the world are threatened by near-field tsunami hazards that may inundate low-lying areas only minutes after a tsunami begins. Geospatial integration of demographic data and hazard zones has identified potential impacts on populations in communities susceptible to near-field tsunami threats. Pedestrian-evacuation models build on these geospatial analyses to determine if individuals in tsunami-prone areas will have sufficient time to reach high ground before tsunami-wave arrival. Areas where successful evacuations are unlikely may warrant vertical-evacuation (VE) strategies, such as berms or structures designed to aid evacuation. The decision of whether and where VE strategies are warranted is complex. Such decisions require an interdisciplinary understanding of tsunami hazards, land cover conditions, demography, community vulnerability, pedestrian-evacuation models, land-use and emergency-management policy, and decision science. Engagement with the at-risk population and local emergency managers in VE planning discussions is critical because resulting strategies include permanent structures within a community and their local ownership helps ensure long-term success. We present a summary of an interdisciplinary approach to assess VE options in communities along the southwest Washington coast (U.S.A.) that are threatened by near-field tsunami hazards generated by Cascadia subduction zone earthquakes. Pedestrian-evacuation models based on an anisotropic approach that uses path-distance algorithms were merged with population data to forecast the distribution of at-risk individuals within several communities as a function of travel time to safe locations. A series of community-based workshops helped identify potential VE options in these communities, collectively known as "Project Safe Haven" at the State of Washington Emergency Management Division. Models of the influence of stakeholder-driven VE options identified changes in the type and distribution of at-risk individuals. Insights from VE use and performance as an aid to evacuations from the 2011 Tohoku tsunami helped to inform the meetings and the analysis. We developed geospatial tools to automate parts of the pedestrian-evacuation models to support the iterative process of developing VE options and forecasting changes in population exposure. Our summary presents the interdisciplinary effort to forecast population impacts from near-field tsunami threats and to develop effective VE strategies to minimize fatalities in future events.

[Psychiatric patient: the most vulnerable traveller].

PubMed

Felkai, Péter; Kurimay, Tamás; Fülöp, Emoke

2011-01-23

Authors analyse questions of medical evacuation of the psychotic patient from abroad to homeland. This task can be considered the most difficult problem for the attending physician and the escorting medical team as well. The main challenge is to recognise the psychotic patient in a foreign country with a different health-care system and to overcome the language barrier and the different cultural background. The second issue is to prepare the patients - who are usually in a poor condition - for the medical evacuation by commercial aircraft. Another important issue is to take the patient through the strict security control. All of these (partially unsolved) problems make the mentally ill patient defenceless. Although the repatriation of a mentally ill patient is vital and urgent, travel insurance policy mostly excludes to cover the cost of treatment and repatriation. The high cost of treatment and repatriation of the patient should be paid by the patient or the family, who are often in the position of insolvency. In this paper authors present the history of a patient and give a brief review on travel-related mental disorders, the epidemiology of mental alterations during travel as well as the problems of appropriate evacuation. Authors conclude that there is a need for a better approach of the airport authorities and insurance decision makers to the mentally ill patient travelling abroad.

A novel technique for bedside anorectal manometry in humans.

PubMed

Bharucha, A E; Stroetz, R; Feuerhak, K; Szarka, L A; Zinsmeister, A R

2015-10-01

Currently, anorectal manometry (ARM), which is used to diagnose defecatory disorders and identify anal weakness in fecal incontinence (FI) is generally conducted in specialized laboratories. Our aims were to compare anorectal functions measured with high-resolution manometry (HRM) and a novel portable manometry device. Anal pressures at rest, during squeeze, and simulated evacuation, and rectal sensation were evaluated with portable and HRM in 20 healthy women, 19 women with constipation, and 11 with FI. The relationship between anal pressures measured with portable and HRM was assessed by the concordance correlation coefficient (CCC), Bland Altman test, and paired t-tests. Anal pressures at rest (CCC 0.45; 95% CI: 0.29, 0.58) and during squeeze (CCC 0.60; 95% CI: 0.46, 0.72) measured with portable and HRM were correlated and inversely associated with the risk of FI. During simulated evacuation, the CCC for rectal pressure (0.62; 95% CI: 0.43, 0.76) was greater than that for anal pressure (CCC 0.22; 95% CI: 0.04, 0.39) and the rectoanal gradient (CCC 0.22; 95% CI: 0.02, 0.41). Rectal sensory thresholds for first sensation, the desire to defecate, and urgency measured by portable and HRM were also significantly correlated between techniques. For several parameters, differences between portable and HRM were statistically significant and the Bland Altman test was positive. Anorectal pressures and rectal sensation can be conveniently measured by portable manometry and are significantly correlated with high-resolution manometry. © 2015 John Wiley & Sons Ltd.

Evacuating People and Their Pets: Older Floridians' Need for and Proximity to Pet-Friendly Shelters.

PubMed

Douglas, Rachel; Kocatepe, Ayberk; Barrett, Anne E; Ozguven, Eren Erman; Gumber, Clayton

2017-10-04

Pets influence evacuation decisions, but little is known about pet-friendly emergency shelters' availability or older adults' need for them. Our study addresses this issue, focusing on the most densely populated area of Florida (Miami-Dade)-the state with the oldest population and greatest hurricane susceptibility. We use Geographic Information Systems (GIS)-based methodology to identify the shortest paths to pet-friendly shelters, based on distance and congested and uncongested travel times-taking into account the older population's spatial distribution. Logistic regression models using the 2013 American Housing Survey's Disaster Planning Module examine anticipated shelter use as a function of pet ownership and requiring pet evacuation assistance. Thirty-four percent of older adults in the Miami-Dade area have pets-35% of whom report needing pet evacuation assistance. However, GIS accessibility measures show that travel time factors are likely to impede older adults' use of the area's few pet-friendly shelters. Logistic regression results reveal that pet owners are less likely to report anticipating shelter use; however, the opposite holds for pet owners reporting they would need help evacuating their pets-they anticipate using shelters. High pet shelter need coupled with low availability exacerbates older adults' heightened vulnerability during Florida's hurricane season. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Internal anal sphincter myopathy causing proctalgia fugax and constipation: further clinical and radiological characterization in a patient.

PubMed

Guy, R J; Kamm, M A; Martin, J E

1997-02-01

We report a case of a distinctive familial internal anal sphincter myopathy with unique histological and radiological features. A 67-year-old woman presented with a 20-year history of proctalgia fugax and outlet obstruction; other family members were similarly affected. Computed tomograpy and magnetic resonance imaging demonstrated a grossly hypertrophied internal anal sphincter. Strip myectomy of the sphincter was carried out with improvement in evacuation but little relief of proctalgia. Further relief of symptoms was obtained using oral and transdermal nitrates and a calcium antagonist. Histological examination of the excised muscle revealed hypertrophy and an abnormal arrangement of fibres in whorls; many fibres contained vacuoles with inclusion bodies positive for periodic acid-Schiff. This description of a specific anal sphincter myopathy illustrates the potential importance of histopathological studies of smooth muscle in functional disorders of the gut.

Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

NASA Astrophysics Data System (ADS)

Fraser, S. A.; Wood, N. J.; Johnston, D. M.; Leonard, G. S.; Greening, P. D.; Rossetto, T.

2014-11-01

Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate departure or a common evacuation departure time for all exposed population. Here, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The method is demonstrated for hypothetical local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios. However, it requires detailed exposure data, which may preclude its use in many situations.

Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

NASA Astrophysics Data System (ADS)

Fraser, S. A.; Wood, N. J.; Johnston, D. M.; Leonard, G. S.; Greening, P. D.; Rossetto, T.

2014-06-01

Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate evacuation departure time or assumed a common departure time for all exposed population. In this paper, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The model is demonstrated for a case study of local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb-level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds can approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios.

Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

USGS Publications Warehouse

Fraser, Stuart A.; Wood, Nathan J.; Johnston, David A.; Leonard, Graham S.; Greening, Paul D.; Rossetto, Tiziana

2014-01-01

Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate departure or a common evacuation departure time for all exposed population. Here, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The method is demonstrated for hypothetical local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios. However, it requires detailed exposure data, which may preclude its use in many situations.

Evacuation of Intensive Care Units During Disaster: Learning From the Hurricane Sandy Experience.

PubMed

King, Mary A; Dorfman, Molly V; Einav, Sharon; Niven, Alex S; Kissoon, Niranjan; Grissom, Colin K

2016-02-01

Data on best practices for evacuating an intensive care unit (ICU) during a disaster are limited. The impact of Hurricane Sandy on New York City area hospitals provided a unique opportunity to learn from the experience of ICU providers about their preparedness, perspective, roles, and activities. We conducted a cross-sectional survey of nurses, respiratory therapists, and physicians who played direct roles during the Hurricane Sandy ICU evacuations. Sixty-eight health care professionals from 4 evacuating hospitals completed surveys (35% ICU nurses, 21% respiratory therapists, 25% physicians-in-training, and 13% attending physicians). Only 21% had participated in an ICU evacuation drill in the past 2 years and 28% had prior training or real-life experience. Processes were inconsistent for patient prioritization, tracking, transport medications, and transport care. Respondents identified communication (43%) as the key barrier to effective evacuation. The equipment considered most helpful included flashlights (24%), transport sleds (21%), and oxygen tanks and respiratory therapy supplies (19%). An evacuation wish list included walkie-talkies/phones (26%), lighting/electricity (18%), flashlights (10%), and portable ventilators and suction (16%). ICU providers who evacuated critically ill patients during Hurricane Sandy had little prior knowledge of evacuation processes or vertical evacuation experience. The weakest links in the patient evacuation process were communication and the availability of practical tools. Incorporating ICU providers into hospital evacuation planning and training, developing standard evacuation communication processes and tools, and collecting a uniform dataset among all evacuating hospitals could better inform critical care evacuation in the future.

Variations in population exposure and evacuation potential to multiple tsunami evacuation phases on Alameda and Bay Farm Islands, California

NASA Astrophysics Data System (ADS)

Peters, J.

2015-12-01

Planning for a tsunami evacuation is challenging for California communities due to the variety of earthquake sources that could generate a tsunami. A maximum tsunami inundation zone is currently the basis for all tsunami evacuations in California, although an Evacuation Playbook consisting of specific event-based evacuation phases relating to flooding severity is in development. We chose to investigate the Evacuation Playbook approach for the island community of Alameda, CA since past reports estimated a significant difference in numbers of residents in the maximum inundation zone when compared to an event-based inundation zone. In order to recognize variations in the types of residents and businesses within each phase, a population exposure analysis was conducted for each of the four Alameda evacuation phases. A pedestrian evacuation analysis using an anisotropic, path distance model was also conducted to understand the time it would take for populations to reach high ground by foot. Initial results suggest that the two islands of the City of Alameda have different situations when it comes to the four tsunami evacuation phases. Pedestrian evacuation results suggest that Bay Farm Island would have more success evacuating by vehicle due to limited nearby high ground for pedestrians to reach safety. Therefore, agent-based traffic simulation software was used to model vehicle evacuation off Bay Farm Island. Initial results show that Alameda Island could face challenges evacuating numerous boat docks and a large beach for phases 1 and 2, whereas Bay Farm Island is unaffected at these phases but might be challenged with evacuating by vehicle for phases 3 and maximum due to congestion on limited egress routes. A better understanding of the population exposure within each tsunami Evacuation Playbook phase and the time it would take to evacuate out of each phase by foot or vehicle will help emergency managers implement the evacuation phases during an actual tsunami event.

Experimental study on occupant evacuation in narrow seat aisle

NASA Astrophysics Data System (ADS)

Huang, Shenshi; Lu, Shouxiang; Lo, Siuming; Li, Changhai; Guo, Yafei

2018-07-01

Narrow seat aisle is an important area in the train car interior due to the large passenger population, however evacuation therein has not gained enough concerns. In this experimental study, the occupant evacuation of the narrow seat aisle area is investigated, with the aisle width of 0.4-0.6 m and the evacuation direction of forward and backward. The evacuation behaviors are analyzed based on the video record, and the discussion is carried out in the aspect of evacuation time, crowdedness, evacuation order, and aisle conflicts. The result shows that with the increasing aisle width, total evacuation time and the average specific evacuation rate decrease. The aisle is crowded for some time, with a large linear occupant densities. The evacuation order of each occupant is mainly related to the seat position. Moreover, it is found that the aisle conflicts can be well described by Burstedde's model. This study gives a useful benchmark for evacuation simulation of narrow seat aisle, and provides reference to safety design of seat area in train cars.

Modeling pedestrian evacuation with guiders based on a multi-grid model

NASA Astrophysics Data System (ADS)

Cao, Shuchao; Song, Weiguo; Lv, Wei

2016-02-01

Pedestrian evacuation with guidance is investigated by a multi-grid model in this paper. The effects of guider type, guider number, guider distribution and guidance strategy on evacuation are discussed. From the analysis of simulation results, it is found that the identified guiders are more beneficial to evacuation because they can be distinguished easily by pedestrians during evacuation; The optimal guider number exists in view of the human cost and can be obtained in our model; The uniform distribution of guiders covers more area in the room and makes evacuation efficient; Evacuation guidance is more effective when the speed of guider is about 75% of herding pedestrian's speed in our simulation scenario; The performance of evacuation guidance strategy considering both distance and occupant number is the best when compared to other strategies; The coordination and cooperation between guiders are very important and necessary to facilitate the evacuation. The study may be useful for understanding the importance of guidance in evacuation and developing efficient evacuation strategy for management under emergency.

Predictive value of impaired evacuation at proctography in diagnosing anismus.

PubMed

Halligan, S; Malouf, A; Bartram, C I; Marshall, M; Hollings, N; Kamm, M A

2001-09-01

We aimed to determine the positive predictive value of impaired evacuation during evacuation proctography for the subsequent diagnosis of anismus. Thirty-one adults with signs of impaired evacuation (defined as the inability to evacuate two thirds of a 120 mL contrast enema within 30 sec) during evacuation proctography underwent subsequent anorectal physiologic testing for anismus. A physiologic diagnosis of anismus was based on a typical clinical history of the condition combined with impaired rectal balloon expulsion or abnormal surface electromyogram. Twenty-eight (90%) of the 31 patients with impaired proctographic evacuation were found to have anismus at subsequent physiologic testing. Among the 28 were all 10 patients who evacuated no contrast medium and all 11 patients with inadequate pelvic floor descent, giving evacuation proctography a positive predictive value of 90% for the diagnosis of anismus. A prominent puborectal impression was seen in only three subjects during proctography, one of whom subsequently showed no physiologic sign of anismus. Impaired evacuation during evacuation proctography is highly predictive for diagnosis of anismus.

Ergonomics intervention on an alternative design of a spinal board.

PubMed

Zadry, Hilma Raimona; Susanti, Lusi; Rahmayanti, Dina

2017-09-01

A spinal board is the evacuation tool of first aid to help the injured spinal cord. The existing spinal board has several weaknesses, both in terms of user comfort and the effectiveness and efficiency of the evacuation process. This study designs an ergonomic spinal board using the quality function deployment approach. A preliminary survey was conducted through direct observation and interviews with volunteers from the Indonesian Red Cross. Data gathered were translated into a questionnaire and answered by 47 participants in West Sumatra. The results indicate that the selection of materials, the application of strap systems as well as the addition of features are very important in designing an ergonomic spinal board. The data were used in designing an ergonomic spinal board. The use of anthropometric data ensures that this product can accommodate safety and comfort when immobilized, as well as the flexibility and speed of the rescue evacuation process.

Asthma exacerbations after the East Japan Disaster.

PubMed

Ishiura, Yoshihisa; Fujimura, Masaki; Yamamoto, Hiroki; Shiba, Yasutaka; Ohkura, Noriyuki; Kasahara, Kazuo; Ishida, Youichi

2013-01-01

On March 11, 2011, a 9.0-magnitude earthquake struck east Japan, following tsunami. Many people are forced to live in evacuation shelters without enough life-saving drugs. Asthma control for management of health crisis is required, because asthma exacerbation is a major cause of morbidity, can need acute care and results in death. However, it remains obscure what parameter should be used in primary clinic of evacuation shelters. The objective of this study is to elucidate the practical efficacy of asthma assessment tool in primary clinic for victims of this disaster. Asthma control test (ACT), a brief and patient-based tool to evaluate asthma control, was conducted for 17 patients with asthma in evacuation shelters at Tohoku district. Total sum of ACT scores were significantly decreased after this disaster. Significant decreases were observed for the items; "Asthma keeps you from getting much done at work", "Shortness of breath", "Asthma symptoms wake you up" and "Patient rating of control". ACT, an easy and practicable tool, clearly demonstrated the asthma exacerbation in evacuation shelters without the use of lung function testing. ACT may contribute to the management of health crisis not only for this East Japan disaster but also for the other forthcoming unavoidable disasters.

Dynamic decision making for dam-break emergency management - Part 1: Theoretical framework

NASA Astrophysics Data System (ADS)

Peng, M.; Zhang, L. M.

2013-02-01

An evacuation decision for dam breaks is a very serious issue. A late decision may lead to loss of lives and properties, but a very early evacuation will incur unnecessary expenses. This paper presents a risk-based framework of dynamic decision making for dam-break emergency management (DYDEM). The dam-break emergency management in both time scale and space scale is introduced first to define the dynamic decision problem. The probability of dam failure is taken as a stochastic process and estimated using a time-series analysis method. The flood consequences are taken as functions of warning time and evaluated with a human risk analysis model (HURAM) based on Bayesian networks. A decision criterion is suggested to decide whether to evacuate the population at risk (PAR) or to delay the decision. The optimum time for evacuating the PAR is obtained by minimizing the expected total loss, which integrates the time-related probabilities and flood consequences. When a delayed decision is chosen, the decision making can be updated with available new information. A specific dam-break case study is presented in a companion paper to illustrate the application of this framework to complex dam-breaching problems.

A method of emotion contagion for crowd evacuation

NASA Astrophysics Data System (ADS)

Cao, Mengxiao; Zhang, Guijuan; Wang, Mengsi; Lu, Dianjie; Liu, Hong

2017-10-01

The current evacuation model does not consider the impact of emotion and personality on crowd evacuation. Thus, there is large difference between evacuation results and the real-life behavior of the crowd. In order to generate more realistic crowd evacuation results, we present a method of emotion contagion for crowd evacuation. First, we combine OCEAN (Openness, Extroversion, Agreeableness, Neuroticism, Conscientiousness) model and SIS (Susceptible Infected Susceptible) model to construct the P-SIS (Personalized SIS) emotional contagion model. The P-SIS model shows the diversity of individuals in crowd effectively. Second, we couple the P-SIS model with the social force model to simulate emotional contagion on crowd evacuation. Finally, the photo-realistic rendering method is employed to obtain the animation of crowd evacuation. Experimental results show that our method can simulate crowd evacuation realistically and has guiding significance for crowd evacuation in the emergency circumstances.

A spatiotemporal optimization model for the evacuation of the population exposed to flood hazard

NASA Astrophysics Data System (ADS)

Alaeddine, H.; Serrhini, K.; Maizia, M.

2015-03-01

Managing the crisis caused by natural disasters, and especially by floods, requires the development of effective evacuation systems. An effective evacuation system must take into account certain constraints, including those related to traffic network, accessibility, human resources and material equipment (vehicles, collecting points, etc.). The main objective of this work is to provide assistance to technical services and rescue forces in terms of accessibility by offering itineraries relating to rescue and evacuation of people and property. We consider in this paper the evacuation of an urban area of medium size exposed to the hazard of flood. In case of inundation, most people will be evacuated using their own vehicles. Two evacuation types are addressed in this paper: (1) a preventive evacuation based on a flood forecasting system and (2) an evacuation during the disaster based on flooding scenarios. The two study sites on which the developed evacuation model is applied are the Tours valley (Fr, 37), which is protected by a set of dikes (preventive evacuation), and the Gien valley (Fr, 45), which benefits from a low rate of flooding (evacuation before and during the disaster). Our goal is to construct, for each of these two sites, a chronological evacuation plan, i.e., computing for each individual the departure date and the path to reach the assembly point (also called shelter) according to a priority list established for this purpose. The evacuation plan must avoid the congestion on the road network. Here we present a spatiotemporal optimization model (STOM) dedicated to the evacuation of the population exposed to natural disasters and more specifically to flood risk.

A spatio-temporel optimization model for the evacuation of the population exposed to natural disasters

NASA Astrophysics Data System (ADS)

Alaeddine, H.; Serrhini, K.; Maïzia, M.; Néron, E.

2015-01-01

The importance of managing the crisis caused by natural disasters, and especially by flood, requires the development of an effective evacuation systems. An effective evacuation system must take into account certain constraints, including those related to network traffic, accessibility, human resources and material equipment (vehicles, collecting points, etc.). The main objective of this work is to provide assistance to technical services and rescue forces in terms of accessibility by offering itineraries relating to rescue and evacuation of people and property. We consider in this paper the evacuation of an urban area of medium size exposed to the hazard of flood. In case of inundation, most people will be evacuated using their own vehicles. Two evacuation types are addressed in this paper, (1) a preventive evacuation based on a flood forecasting system and (2) an evacuation during the disaster based on flooding scenarios. The two study sites on which the evacuation model developed is applied are the valley of Tours (Fr, 37) which is protected by a set of dikes (preventive evacuation) and the valley of Gien (Fr, 45) which benefits of a low rate of flooding (evacuation before and during the disaster). Our goal is to construct, for each of these two sites, a chronological evacuation plan i.e. computing for each individual the departure date and the path to reach the assembly point (also called shelter) associated according to a priorities list established for this purpose. Evacuation plan must avoid the congestion on the road network. Here we present a Spatio-Temporal Optimization Model (STOM) dedicated to the evacuation of the population exposed to natural disasters and more specifically to flood risk.

Was the Risk from Nursing-Home Evacuation after the Fukushima Accident Higher than the Radiation Risk?

PubMed

Murakami, Michio; Ono, Kyoko; Tsubokura, Masaharu; Nomura, Shuhei; Oikawa, Tomoyoshi; Oka, Tosihiro; Kami, Masahiro; Oki, Taikan

2015-01-01

After the 2011 accident at the Fukushima Daiichi nuclear power plant, nursing-home residents and staff were evacuated voluntarily from damaged areas to avoid radiation exposure. Unfortunately, the evacuation resulted in increased mortalities among nursing home residents. We assessed the risk trade-off between evacuation and radiation for 191 residents and 184 staff at three nursing homes by using the same detriment indicator, namely loss of life expectancy (LLE), under four scenarios, i.e. "rapid evacuation (in accordance with the actual situation; i.e. evacuation on 22 March)," "deliberate evacuation (i.e. evacuation on 20 June)," "20-mSv exposure," and "100-mSv exposure." The LLE from evacuation-related mortality among nursing home residents was assessed with survival probability data from nursing homes in the city of Minamisoma and the city of Soma. The LLE from radiation mortality was calculated from the estimated age-specific mortality rates from leukemia and all solid cancers based on the additional effective doses and the survival probabilities. The total LLE of residents due to evacuation-related risks in rapid evacuation was 11,000 persons-d-much higher than the total LLEs of residents and staff due to radiation in the other scenarios (27, 1100, and 5800 persons-d for deliberate evacuation, 20 mSv-exposure, and 100 mSv-exposure, respectively). The latitude for reducing evacuation risks among nursing home residents is surprisingly large. Evacuation regulation and planning should therefore be well balanced with the trade-offs against radiation risks. This is the first quantitative assessment of the risk trade-off between radiation exposure and evacuation after a nuclear power plant accident.

Study on Earthquake Emergency Evacuation Drill Trainer Development

NASA Astrophysics Data System (ADS)

ChangJiang, L.

2016-12-01

With the improvement of China's urbanization, to ensure people survive the earthquake needs scientific routine emergency evacuation drills. Drawing on cellular automaton, shortest path algorithm and collision avoidance, we designed a model of earthquake emergency evacuation drill for school scenes. Based on this model, we made simulation software for earthquake emergency evacuation drill. The software is able to perform the simulation of earthquake emergency evacuation drill by building spatial structural model and selecting the information of people's location grounds on actual conditions of constructions. Based on the data of simulation, we can operate drilling in the same building. RFID technology could be used here for drill data collection which read personal information and send it to the evacuation simulation software via WIFI. Then the simulation software would contrast simulative data with the information of actual evacuation process, such as evacuation time, evacuation path, congestion nodes and so on. In the end, it would provide a contrastive analysis report to report assessment result and optimum proposal. We hope the earthquake emergency evacuation drill software and trainer can provide overall process disposal concept for earthquake emergency evacuation drill in assembly occupancies. The trainer can make the earthquake emergency evacuation more orderly, efficient, reasonable and scientific to fulfill the increase in coping capacity of urban hazard.

Tsunami evacuation simulation considering differences in evacuation means depending on the household attribute

NASA Astrophysics Data System (ADS)

Sugiki, Nao; Hirata, Yoshiki; Matsuo, Kojiro

2017-10-01

Large scale earthquakes occur frequently in Japan in recent years. In the Great East Japan Earthquake that occurred in 2011 and caused major damage, more than 90% of the dead were due to the tsunami. The speed of evacuation is important in considering evacuation at the time of the attack of the tsunami, especially the elderly evacuation speed is assumed to be slower than non-elderly people. Elderly people may have different means of evacuation and speed depending on the composition of the households to which they belong because of the different possibilities of riding in families' driven cars. However, a simulation taking such a difference of evacuation into consideration has not been conducted. The purpose of this study is to conduct a tsunami evacuation simulation in consideration of evacuation measures and speed depending on the type of households belonging to in the tsunami inundation area of Toyohashi city, Japan. In order to conduct the tsunami evacuation simulation considering the household type, detailed data on individual households is necessary. However, it is difficult to obtain from aggregated data such as National Census. Therefore, detailed data on individual households is created by using the household micro data estimation system developed by Sugiki et al. [1]. Evacuation simulation is performed by shortest path search using Esri's ArcGIS Network Analyst's OD cost matrix analysis. The elderly people who cannot complete evacuation by the time of the arrival of the tsunami were found from evacuation simulation results assuming evacuation measures available for each household attribute to which the evacuees belong.

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Marine evacuation system launching arrangements. 133.145... LIFESAVING SYSTEMS Requirements for All OSVs § 133.145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each marine evacuation...

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Marine evacuation system launching arrangements. 133.145... LIFESAVING SYSTEMS Requirements for All OSVs § 133.145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each marine evacuation...

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Marine evacuation system launching arrangements. 133.145... LIFESAVING SYSTEMS Requirements for All OSVs § 133.145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each marine evacuation...

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Marine evacuation system launching arrangements. 133.145... LIFESAVING SYSTEMS Requirements for All OSVs § 133.145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each marine evacuation...

[Clinical practice guidelines: Irritable bowel syndrome with constipation and functional constipation in adults: Concept, diagnosis, and healthcare continuity. (Part 1 of 2)].

PubMed

Mearin, F; Ciriza, C; Mínguez, M; Rey, E; Mascort, J J; Peña, E; Cañones, P; Júdez, J

In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

[Clinical practice guidelines: Irritable bowel syndrome with constipation and functional constipation in adults: Concept, diagnosis, and healthcare continuity. (Part 1 of 2)].

PubMed

Mearin, F; Ciriza, C; Mínguez, M; Rey, E; Mascort, J J; Peña, E; Cañones, P; Júdez, J

2017-01-01

In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them. Copyright © 2016. Publicado por Elsevier España, S.L.U.

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

Can cooperative behaviors promote evacuation efficiency?

NASA Astrophysics Data System (ADS)

Cheng, Yuan; Zheng, Xiaoping

2018-02-01

This study aims to get insight into the question whether cooperative behaviors can promote the evacuation efficiency during an evacuation process. In this work, cooperative behaviors and evacuation efficiency have been examined in detail by using a cellular automata model with behavioral extension. The simulation results show that moderate cooperative behaviors can result in the highest evacuation efficiency. It is found that in a mixture of cooperative and competitive individuals, more cooperative people will lead to relatively high evacuation efficiency, and the larger subgroup will play a leading role. This work can also provide some new insights for the study of cooperative behaviors and evacuation efficiency which can be a scientific decision-making basis for emergency response involving large-scale crowd evacuation in emergencies.

Reflection on Lessons Learned: An Analysis of the Adverse Outcomes Observed During the Hurricane Rita Evacuation.

PubMed

Baker, Karen

2018-02-01

In September 2005, nearly 3.7 million people evacuated the Texas coastline in advance of Hurricane Rita's landfall, making the event the largest emergency evacuation in US history. The Rita evacuation underscored the importance of planning for domestic mass-evacuation events, as the evacuation itself led to over 100 of the at least 119 deaths attributed to the storm. In the days preceding Rita's landfall, several cascading, interrelated circumstances precipitated such adverse outcomes. This article explores the series of events leading up to the evacuation's poor outcomes, the response following Rita to amend evacuation plans, and how Texas successfully implemented these changes during later storms to achieve better outcomes. (Disaster Med Public Health Preparedness. 2018;12:115-120).

The long-term impact of war experiences and evacuation on people who were children during World War Two.

PubMed

Waugh, Melinda J; Robbins, Ian; Davies, Stephen; Feigenbaum, Janet

2007-03-01

During World War Two 1.9 million people were evacuated from British cities where the risk of bombing was perceived to be highest. 1.5 million of these were children who, often unaccompanied, were sent to live with strangers. Two hundred and forty-five people who were evacuated as children were compared with 96 of similar age who did not experience evacuation. Within this self-selected sample, significant numbers of the evacuees were found to have experienced abuse and neglect. Pre-evacuation abuse made continued abuse likely during evacuation, while abuse during evacuation led to children being more likely to continue to be abused on their return home. Abuse during evacuation led to increased scores on the Impact of Event Scale and General Health Questionnaire, and to insecure attachment patterns. The role of evacuation and abuse in the maintenance of long-term psychological problems is discussed.

A microcomputer based traffic evacuation modeling system for emergency planning application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rathi, A.K.

1994-12-01

Vehicular evacuation is one of the major and often preferred protective action options available for emergency management in a real or anticipated disaster. Computer simulation models of evacuation traffic flow are used to estimate the time required for the affected populations to evacuate to safer areas, to evaluate effectiveness of vehicular evacuations as a protective action option. and to develop comprehensive evacuation plans when required. Following a review of the past efforts to simulate traffic flow during emergency evacuations, an overview of the key features in Version 2.0 of the Oak Ridge Evacuation Modeling System (OREMS) are presented in thismore » paper. OREMS is a microcomputer-based model developed to simulate traffic flow during regional emergency evacuations. OREMS integrates a state-of-the-art dynamic traffic flow and simulation model with advanced data editing and output display programs operating under a MS-Windows environment.« less

Nursing home evacuation plans.

PubMed

Castle, Nicholas G

2008-07-01

I examined evacuation plans from 2134 nursing homes and analyzed national data to determine the types of nursing homes cited for deficiencies in their evacuation plans. Evacuation plans were assessed according to criteria developed by an expert panel funded by the Office of the Inspector General. Deficiency citations came from the Online Survey, Certification, and Recording database, collected from 1997 to 2005. Four specific citations, for written emergency plans, staff training, written evacuation plans, and fire drills, were examined with multivariate logistic regression. Most plans had water supply provisions (96%). Only 31% specified an evacuation route. The rate of citations was relatively stable throughout the study period: each year approximately 0.6% of facilities were found to be deficient in written emergency plans, 2.1% in staff training, 1.2% in written evacuation plans, and 7.9% in fire drills. Some nursing homes need more specific evacuation plans. Water supply was the most and evacuation routes were the least well-addressed areas.

A study on evacuation time from lecture halls in Faculty of Engineering, Universiti Putra Malaysia

NASA Astrophysics Data System (ADS)

Othman, W. N. A. W.; Tohir, M. Z. M.

2018-04-01

An evacuation situation in any building involves many risks. The geometry of building and high potential of occupant load may affect the efficiency of evacuation process. Although fire safety rules and regulations exist, they remain insufficient to guarantee the safety of all building occupants and do not prevent the dramatic events to be repeated. The main objective of this project is to investigate the relationship between the movement time, travel speed and occupant density during a series of evacuation drills specifically for lecture halls. Generally, this study emphasizes on the movement of crowd within a limited space and includes the aspects of human behaviour. A series of trial evacuations were conducted in selected lecture halls at Faculty of Engineering, Universiti Putra Malaysia with the aim of collecting actual data for numerical analysis. The numerical data obtained during trial evacuations were used to determine the evacuation time, crowd movement and behaviour during evacuation process particularly for lecture halls. The evacuation time and number of occupants exiting from each exit were recorded. Video camera was used to record and observe the movement behaviour of occupants during evacuations. EvacuatioNZ was used to simulate the trials evacuations of DK 5 and the results predicted were compared with experimental data. EvacuatioNZ was also used to predict the evacuation time and the flow of occupants exiting from each door for DK 4 and DK 8.

Diagnosis and Management of Lower Urinary Tract Dysfunction.

PubMed

McDonough, Robert C; Ryan, Stephen T

2016-06-01

Lower urinary tract dysfunction is an umbrella diagnosis that covers difficulty evacuating urine from the bladder. In its most simple form, it is either an inability to store urine or an inability to empty the bladder of urine appropriately. The normal and the abnormal bladder, the role of urodynamics in evaluation of lower urinary tract dysfunction, and the medical and behavioral management of some of these disorders are reviewed. Copyright © 2016 Elsevier Inc. All rights reserved.

Optimization-based decision support to assist in logistics planning for hospital evacuations.

PubMed

Glick, Roger; Bish, Douglas R; Agca, Esra

2013-01-01

The evacuation of the hospital is a very complex process and evacuation planning is an important part of a hospital's emergency management plan. There are numerous factors that affect the evacuation plan including the nature of threat, availability of resources and staff the characteristics of the evacuee population, and risk to patients and staff. The safety and health of patients is of fundamental importance, but safely moving patients to alternative care facilities while under threat is a very challenging task. This article describes the logistical issues and complexities involved in planning and execution of hospital evacuations. Furthermore, this article provides examples of how optimization-based decision support tools can help evacuation planners to better plan for complex evacuations by providing real-world solutions to various evacuation scenarios.

Diagnosis and Treatment of Dyssynergic Defecation

PubMed Central

Rao, Satish S C; Patcharatrakul, Tanisa

2016-01-01

Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights. Recently, randomized controlled trials have shown that biofeedback therapy is more effective than laxatives and other modalities, both in the short term and long term, without side effects. Also, symptom improvements correlated with changes in underlying pathophysiology. Biofeedback therapy has been recommended as the first-line of treatment for dyssynergic defecation. Here, we provide an overview of the burden of illness and pathophysiology of dyssynergic defecation, and how to diagnose and treat this condition with biofeedback therapy. PMID:27270989

Alcohol use disorder due to social isolation after a nuclear disaster in Fukushima

PubMed Central

Morita, Tomohiro; Tanimoto, Tetsuya; Hori, Arinobu; Kanazawa, Yukio

2015-01-01

It is well-known that a nuclear disaster causes health problems including cancer, however, information on mental disorders linked to a nuclear disaster is limited. On 11 March 2011, there was a serious nuclear power plant accident in Fukushima, Japan. Subsequently, in October 2012, a 78-year-old man living 31 km from the plant was admitted to the hospital with head trauma. This was his third physical trauma since the nuclear accident. A thorough interview revealed that his alcohol intake had increased after the disaster, suggesting that his injuries might be related to alcohol use. The diagnosis of alcohol use disorder was established based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. He had been exposed to social isolation after evacuation of his neighbourhood. Using education and intervention, he was successfully treated. We should recognise that a nuclear disaster might cause social isolation among the elderly, leading to mental disorders and alcohol use disorder. Early diagnosis and intervention might be beneficial for individuals presenting the above symptoms. PMID:26101299

Alcohol use disorder due to social isolation after a nuclear disaster in Fukushima.

PubMed

Morita, Tomohiro; Tanimoto, Tetsuya; Hori, Arinobu; Kanazawa, Yukio

2015-06-21

It is well-known that a nuclear disaster causes health problems including cancer, however, information on mental disorders linked to a nuclear disaster is limited. On 11 March 2011, there was a serious nuclear power plant accident in Fukushima, Japan. Subsequently, in October 2012, a 78-year-old man living 31 km from the plant was admitted to the hospital with head trauma. This was his third physical trauma since the nuclear accident. A thorough interview revealed that his alcohol intake had increased after the disaster, suggesting that his injuries might be related to alcohol use. The diagnosis of alcohol use disorder was established based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. He had been exposed to social isolation after evacuation of his neighbourhood. Using education and intervention, he was successfully treated. We should recognise that a nuclear disaster might cause social isolation among the elderly, leading to mental disorders and alcohol use disorder. Early diagnosis and intervention might be beneficial for individuals presenting the above symptoms. 2015 BMJ Publishing Group Ltd.

Chronic Constipation and Constipation-Predominant IBS: Separate and Distinct Disorders or a Spectrum of Disease?

PubMed

Siah, Kewin T H; Wong, Reuben K; Whitehead, William E

2016-03-01

Rome III diagnostic criteria separate patients with idiopathic chronic constipation into mutually exclusive categories of constipation-predominant irritable bowel syndrome (IBS-C) or functional constipation (FC). However, several experts think that these conditions are not different disorders, but parts of a continuum. To shed light on this issue, we examined studies that compared IBS-C with FC with respect to symptoms, pathophysiologic mechanisms, and treatment response. When the Rome III requirement that patients meeting criteria for IBS cannot also be given a diagnosis of FC is suspended, most patients meet criteria for both, and, contrary to expectation, IBS-C patients have more symptoms of constipation than patients with FC. No symptoms reliably separate IBS-C from FC. Physiologic tests are not reliably associated with diagnosis, but visceral pain hypersensitivity tends to be more strongly associated with IBS-C than with FC, and delayed colonic transit tends to be more common in FC. Although some treatments are effective for both IBS-C and FC, such as prosecretory agents, other treatments are specific to IBS-C (eg, antidepressants, antispasmodics, cognitive behavior therapy) or FC (eg, prucalopride, biofeedback). Future studies should permit IBS-C and FC diagnoses to overlap. Physiologic tests comparing these disorders should include visceral pain sensitivity, colonic transit time, time to evacuate a water-filled balloon, and anal pressures or electromyographic activity from the anal canal. To date, differential responses to treatment provide the strongest evidence that IBS-C and FC may be different disorders, rather than parts of a spectrum.

Chronic Constipation and Constipation-Predominant IBS: Separate and Distinct Disorders or a Spectrum of Disease?

PubMed Central

Siah, Kewin T. H.; Wong, Reuben K.

2016-01-01

Rome III diagnostic criteria separate patients with idiopathic chronic constipation into mutually exclusive categories of constipation-predominant irritable bowel syndrome (IBS-C) or functional constipation (FC). However, several experts think that these conditions are not different disorders, but parts of a continuum. To shed light on this issue, we examined studies that compared IBS-C with FC with respect to symptoms, pathophysiologic mechanisms, and treatment response. When the Rome III requirement that patients meeting criteria for IBS cannot also be given a diagnosis of FC is suspended, most patients meet criteria for both, and, contrary to expectation, IBS-C patients have more symptoms of constipation than patients with FC. No symptoms reliably separate IBS-C from FC. Physiologic tests are not reliably associated with diagnosis, but visceral pain hypersensitivity tends to be more strongly associated with IBS-C than with FC, and delayed colonic transit tends to be more common in FC. Although some treatments are effective for both IBS-C and FC, such as prosecretory agents, other treatments are specific to IBS-C (eg, antidepressants, antispasmodics, cognitive behavior therapy) or FC (eg, prucalopride, biofeedback). Future studies should permit IBS-C and FC diagnoses to overlap. Physiologic tests comparing these disorders should include visceral pain sensitivity, colonic transit time, time to evacuate a water-filled balloon, and anal pressures or electromyographic activity from the anal canal. To date, differential responses to treatment provide the strongest evidence that IBS-C and FC may be different disorders, rather than parts of a spectrum. PMID:27231446

Analysis of Tsunami Evacuation Issues Using Agent Based Modeling. A Case Study of the 2011 Tohoku Tsunami in Yuriage, Natori.

NASA Astrophysics Data System (ADS)

Mas, E.; Takagi, H.; Adriano, B.; Hayashi, S.; Koshimura, S.

2014-12-01

The 2011 Great East Japan earthquake and tsunami reminded that nature can exceed structural countermeasures like seawalls, breakwaters or tsunami gates. In such situations it is a challenging task for people to find nearby haven. This event, as many others before, confirmed the importance of early evacuation, tsunami awareness and the need for developing much more resilient communities with effective evacuation plans. To support reconstruction activities and efforts on developing resilient communities in areas at risk, tsunami evacuation simulation can be applied to tsunami mitigation and evacuation planning. In this study, using the compiled information related to the evacuation behavior at Yuriage in Natori during the 2011 tsunami, we simulated the evacuation process and explored the reasons for the large number of fatalities in the area. It was found that residents did evacuate to nearby shelter areas, however after the tsunami warning was increased some evacuees decided to conduct a second step evacuation to a far inland shelter. Simulation results show the consequences of such decision and the outcomes when a second evacuation would not have been performed. The actual reported number of fatalities in the event and the results from simulation are compared to verify the model. The case study shows the contribution of tsunami evacuation models as tools to be applied for the analysis of evacuees' decisions and the related outcomes. In addition, future evacuation plans and activities for reconstruction process and urban planning can be supported by the results provided from this kind of tsunami evacuation models.

Gynecologic disorders diagnosed during deployment to Southwest/Central Asia, active component females, U.S. Armed Forces, 2008-2013.

PubMed

2014-08-01

Service women in the U.S. Armed Forces face unique challenges that may lead to or exacerbate gynecologic disorders - particularly during deployment. This report documented that approximately one in 10 military women who served in Southwest/Central Asia were diagnosed with a gynecologic disorder at least once during deployment. In addition, gynecologic disorders accounted for approximately one of every 20 medical evacuations of female service members from the war zone. A majority of clinically significant gynecologic disorder cases were attributable to irregular menstruation/bleeding or unspecified inflammation or pain of the female genital organs. Incidence rates of gynecologic disorder diagnoses were higher among black, non-Hispanic service women, among younger women, and among those in the Army and in motor transport and communications/intelligence occupations. Approximately 50% of gynecologic disorder cases had received gynecologic care within 6 months prior to deployment and nearly 90% had received care within 2 years of deployment. Despite pre-deployment care, it is apparent from this report that service women need continuous access to gynecologic care during deployment, particularly if conditions during deployment lead to and exacerbate gynecologic disorders.

Tsunami evacuation analysis, modelling and planning: application to the coastal area of El Salvador

NASA Astrophysics Data System (ADS)

Gonzalez-Riancho, Pino; Aguirre-Ayerbe, Ignacio; Aniel-Quiroga, Iñigo; Abad Herrero, Sheila; González Rodriguez, Mauricio; Larreynaga, Jeniffer; Gavidia, Francisco; Quetzalcoalt Gutiérrez, Omar; Álvarez-Gómez, Jose Antonio; Medina Santamaría, Raúl

2014-05-01

Advances in the understanding and prediction of tsunami impacts allow the development of risk reduction strategies for tsunami-prone areas. Conducting adequate tsunami risk assessments is essential, as the hazard, vulnerability and risk assessment results allow the identification of adequate, site-specific and vulnerability-oriented risk management options, with the formulation of a tsunami evacuation plan being one of the main expected results. An evacuation plan requires the analysis of the territory and an evaluation of the relevant elements (hazard, population, evacuation routes, and shelters), the modelling of the evacuation, and the proposal of alternatives for those communities located in areas with limited opportunities for evacuation. Evacuation plans, which are developed by the responsible authorities and decision makers, would benefit from a clear and straightforward connection between the scientific and technical information from tsunami risk assessments and the subsequent risk reduction options. Scientifically-based evacuation plans would translate into benefits for the society in terms of mortality reduction. This work presents a comprehensive framework for the formulation of tsunami evacuation plans based on tsunami vulnerability assessment and evacuation modelling. This framework considers (i) the hazard aspects (tsunami flooding characteristics and arrival time), (ii) the characteristics of the exposed area (people, shelters and road network), (iii) the current tsunami warning procedures and timing, (iv) the time needed to evacuate the population, and (v) the identification of measures to improve the evacuation process, such as the potential location for vertical evacuation shelters and alternative routes. The proposed methodological framework aims to bridge the gap between risk assessment and risk management in terms of tsunami evacuation, as it allows for an estimation of the degree of evacuation success of specific management options, as well as for the classification and prioritization of the gathered information, in order to formulate an optimal evacuation plan. The framework has been applied to the El Salvador case study through the project "Tsunami Hazard and Risk Assessment in El Salvador", funded by AECID during the period 2009-12, demonstrating its applicability to site-specific response times and population characteristics.

A hospital system's response to a hurricane offers lessons, including the need for mandatory interfacility drills.

PubMed

Verni, Christina

2012-08-01

This case study explores the lessons learned when the North Shore-Long Island Jewish Health System, a large, integrated health network in New York, evacuated three hospitals at high risk of flooding from Hurricane Irene in August 2011. The episode resulted in the evacuation, transport, and placement of 947 patients without any resulting deaths or serious injuries. This case demonstrates the utility of having in place a functional evacuation plan, such as the one North Shore-Long Island Jewish Health System developed through its own full-scale exercises in the years following Hurricane Katrina in 2005. In those drills, the health system discovered that it needed to abandon its 1:1 matching of patients to available beds in the region in favor of the group transport of patients with similar needs to facilities that could accommodate them. Despite its overall success, the system identified the need for internal improvements, including automated patient tracking through the use of bar-coded wristbands and identification and training of additional backup personnel for its emergency operations center. Among other changes, policy makers at the state and federal levels should consider mandating full-scale interfacility evacuation drills to refine mechanisms to send and receive patients.

Medical management of the consequences of the Fukushima nuclear power plant incident.

PubMed

Hachiya, Misao; Tominaga, Takako; Tatsuzaki, Hideo; Akashi, Makoto

2014-02-01

A huge earthquake struck the northeast coast of the main island of Japan on March 11, 2011, triggering a tsunami with 14-15 meter-high waves hitting the area. The earthquake was followed by numerous sustained aftershocks. The earthquake affected the nuclear power plant (NPP) in Fukushima prefecture, resulting in large amounts of radioactive materials being released into the environment. The major nuclides released on land were ¹³¹I, ¹³⁴Cs, and ¹³⁷Cs. Therefore, almost 170,000 people had to be evacuated or stay indoors. Besides the NPP and the telecommunications system, the earthquake also affected infrastructures such as the supplies of water and electricity as well as the radiation monitoring system. The local hospital system was dysfunctional; hospitals designated as radiation-emergency facilities were not able to function because of damage from the earthquake and tsunami, and some of them were located within a 20 km radius of the NPP, the designated evacuation zone. Local fire department personnel were also asked to evacuate. Furthermore, the affected hospitals had not established their evacuation plans at that time. We have learned from this "combined disaster" that the potential for damage to lifelines as well as the monitoring systems for radiation in case of an earthquake requires our intense focus and vigilance, and that hospitals need comprehensive plans for evacuation, including patients requiring life support equipment during and after a nuclear disaster. There is an urgent need for a "combined disaster" strategy, and this should be emphasized in current disaster planning and response. © 2013 Wiley Periodicals, Inc.

Comparison of calculation and simulation of evacuation in real buildings

NASA Astrophysics Data System (ADS)

Szénay, Martin; Lopušniak, Martin

2018-03-01

Each building must meet requirements for safe evacuation in order to prevent casualties. Therefore methods for evaluation of evacuation are used when designing buildings. In the paper, calculation methods were tested on three real buildings. The testing used methods of evacuation time calculation pursuant to Slovak standards and evacuation time calculation using the buildingExodus simulation software. If calculation methods have been suitably selected taking into account the nature of evacuation and at the same time if correct values of parameters were entered, we will be able to obtain almost identical times of evacuation in comparison with real results obtained from simulation. The difference can range from 1% to 27%.

Evacuation of Swedish survivors after the 2004 Southeast Asian tsunami: The survivors' perspective and symptoms of post-traumatic stress.

PubMed

Gudmundsdottir, Ragnhildur; Hultman, Christina M; Valdimarsdottir, Unnur

2018-04-01

Following the 2004 Southeast Asian tsunami, Swedish authorities received public criticism for slow implementation of rescue work. Meanwhile, data are scarce on survivors' perspectives and potential mental health symptoms associated with timing of evacuation. Therefore, the aim of this study was to investigate survivors' contentment with evacuation time and whether duration at disaster site following the 2004 tsunami was associated with post-traumatic stress symptoms (PTSS) and psychological morbidity. Of 10,116 Swedish tsunami survivors who returned to Sweden in the first 3 weeks post tsunami, 4910 (49%) answered a questionnaire 14 months later including questions on evacuation time, contentment with evacuation time and PTSS (Impact of Event Scale). We used logistic regression to calculate odds ratios (OR) and 95% confidence intervals (95% CI) of PTSS by timing of evacuation adjusting for gender, age, education, various indicators of trauma exposure and pre-tsunami psychiatric diagnoses. More than half of the survivors (53%) were content with evacuation time while 33% wanted later evacuation and 13% earlier evacuation. Compared with those evacuated 14-21 days post tsunami, individuals evacuated at day 1-4 presented with increased odds of PTSS (crude OR 3.0, 95% CI 2.0-4.5; and multivariable adjusted OR 2.0, 95% CI 1.3-3.0) and impaired mental health (crude OR 1.7, 95% CI 1.2-2.4; and multivariable adjusted OR 1.4 95% CI 1.0-2.0). One-third of Swedish tsunami survivors preferred a later evacuation from disaster sites. These findings call for further studies, with prospective designs, to disentangle the causal direction of the association between evacuation time and PTSS.

Computer simulation-based framework for transportation evacuation in major trip generator.

DOT National Transportation Integrated Search

2009-01-01

Since emergencies including both natural disasters and man-made incidents, are happening more and more : frequently, evacuation, especially transportation evacuation, is becoming a hot research focus in recent years. : Currently, transportation evacu...

Surgical Management of the Recent Orbital War Injury.

PubMed

Riyadh, Safaa; Abdulrazaq, Saif Saadedeen; Zirjawi, Ali Mhana Sabeeh

2018-05-08

Maxillofacial trauma affects sensitive and essential functions for the human being such as smell, breathing, talking, and the most importantly the sight. Trauma to the orbit may cause a vision loss especially if this trauma yields a high kinetic energy like that encountered during wars. The purpose of the study was to evaluate the surgical outcomes of the orbital war trauma, enriching the literature with the experience of the authors in this field. A total of 16 patients were injured, evacuated, and managed, between June 2014 and June 2017, from the fight between the Iraqi army and the Islamic State of Iraq and Syria (ISIS) in different areas of Iraq. Two-stage protocol was adopted, that is debridement and reconstruction. There were 14 military patients and 2 civilians. The cause of trauma was either bullet or shrapnel from an explosion. In the battlefield, delayed evacuation of the casualties led to increase the morbidity and mortality. Wearing a protective shield over the eye during the war along with fast evacuation highly improved the survival rates.

Factors associated with high-rise evacuation: qualitative results from the World Trade Center Evacuation Study.

PubMed

Gershon, Robyn R M; Qureshi, Kristine A; Rubin, Marcie S; Raveis, Victoria H

2007-01-01

Due to the fact that most high-rise structures (i.e., >75 feet high, or eight to ten stories) are constructed with extensive and redundant fire safety features, current fire safety procedures typically only involve limited evacuation during minor to moderate fire emergencies. Therefore, full-scale evacuation of high-rise buildings is highly unusual and consequently, little is known about how readily and rapidly high-rise structures can be evacuated fully. Factors that either facilitate or inhibit the evacuation process remain under-studied. This paper presents results from the qualitative phase of the World Trade Center Evacuation Study, a three-year, five-phase study designed to improve our understanding of the individual, organizational, and environmental factors that helped or hindered evacuation from the World Trade Center (WTC) Towers 1 and 2, on 11 September 2001. Qualitative data from semi-structured, in-depth interviews and focus groups involving WTC evacuees were collected and analyzed. On the individual level, factors that affected evacuation included perception of risk (formed largely by sensory cues), preparedness training, degree of familiarity with the building, physical condition, health status, and footwear. Individual behavior also was affected by group behavior and leadership. At the organizational level, evacuation was affected by worksite preparedness planning, including the training and education of building occupants, and risk communication. The environmental conditions affecting evacuation included smoke, flames, debris, general condition and degree of crowdedness on staircases, and communication infrastructure systems (e.g., public address, landline, cellular and fire warden's telephones). Various factors at the individual, organizational, and environmental levels were identified that affected evacuation. Interventions that address the barriers to evacuation may improve the full-scale evacuation of other high-rise buildings under extreme conditions. Further studies should focus on the development and evaluation of targeted interventions, including model emergency preparedness planning for high-rise occupancies.

Experiment and modeling of paired effect on evacuation from a three-dimensional space

NASA Astrophysics Data System (ADS)

Jun, Hu; Huijun, Sun; Juan, Wei; Xiaodan, Chen; Lei, You; Musong, Gu

2014-10-01

A novel three-dimensional cellular automata evacuation model was proposed based on stairs factor for paired effect and variety velocities in pedestrian evacuation. In the model pedestrians' moving probability of target position at the next moment was defined based on distance profit and repulsive force profit, and evacuation strategy was elaborated in detail through analyzing variety velocities and repulsive phenomenon in moving process. At last, experiments with the simulation platform were conducted to study the relationships of evacuation time, average velocity and pedestrian velocity. The results showed that when the ratio of single pedestrian was higher in the system, the shortest route strategy was good for improving evacuation efficiency; in turn, if ratio of paired pedestrians was higher, it is good for improving evacuation efficiency to adopt strategy that avoided conflicts, and priority should be given to scattered evacuation.

Optimization and Planning of Emergency Evacuation Routes Considering Traffic Control

PubMed Central

Zhang, Lijun; Wang, Zhaohua

2014-01-01

Emergencies, especially major ones, happen fast, randomly, as well as unpredictably, and generally will bring great harm to people's life and the economy. Therefore, governments and lots of professionals devote themselves to taking effective measures and providing optimal evacuation plans. This paper establishes two different emergency evacuation models on the basis of the maximum flow model (MFM) and the minimum-cost maximum flow model (MC-MFM), and proposes corresponding algorithms for the evacuation from one source node to one designated destination (one-to-one evacuation). Ulteriorly, we extend our evaluation model from one source node to many designated destinations (one-to-many evacuation). At last, we make case analysis of evacuation optimization and planning in Beijing, and obtain the desired evacuation routes and effective traffic control measures from the perspective of sufficiency and practicability. Both analytical and numerical results support that our models are feasible and practical. PMID:24991636

Exploring the Role of Social Media and Individual Behaviors in Flood Evacuation Processes: An Agent-Based Modeling Approach

NASA Astrophysics Data System (ADS)

Du, Erhu; Cai, Ximing; Sun, Zhiyong; Minsker, Barbara

2017-11-01

Flood warnings from various information sources are important for individuals to make evacuation decisions during a flood event. In this study, we develop a general opinion dynamics model to simulate how individuals update their flood hazard awareness when exposed to multiple information sources, including global broadcast, social media, and observations of neighbors' actions. The opinion dynamics model is coupled with a traffic model to simulate the evacuation processes of a residential community with a given transportation network. Through various scenarios, we investigate how social media affect the opinion dynamics and evacuation processes. We find that stronger social media can make evacuation processes more sensitive to the change of global broadcast and neighbor observations, and thus, impose larger uncertainty on evacuation rates (i.e., a large range of evacuation rates corresponding to sources of information). For instance, evacuation rates are lower when social media become more influential and individuals have less trust in global broadcast. Stubborn individuals can significantly affect the opinion dynamics and reduce evacuation rates. In addition, evacuation rates respond to the percentage of stubborn agents in a nonlinear manner, i.e., above a threshold, the impact of stubborn agents will be intensified by stronger social media. These results highlight the role of social media in flood evacuation processes and the need to monitor social media so that misinformation can be corrected in a timely manner. The joint impacts of social media, quality of flood warnings, and transportation capacity on evacuation rates are also discussed.

An agent-based modelling framework to explore the role of social media and stubborn people on evacuation rates during flooding events

NASA Astrophysics Data System (ADS)

Du, E.; Cai, X.; Minsker, B. S.; Sun, Z.

2017-12-01

Flood warnings from various information sources are important for individuals to make evacuation decisions during a flood event. In this study, we develop a general opinion dynamics model to simulate how individuals update their flood hazard awareness when exposed to multiple information sources, including global broadcast, social media, and observations of neighbors' actions. The opinion dynamics model is coupled with a traffic model to simulate the evacuation processes of a residential community with a given transportation network. Through various scenarios, we investigate how social media affect the opinion dynamics and evacuation processes. We find that stronger social media can make evacuation processes more sensitive to the change of global broadcast and neighbor observations, and thus, impose larger uncertainty on evacuation rates (i.e., a large range of evacuation rates corresponding to sources of information). For instance, evacuation rates are lower when social media become more influential and individuals have less trust in global broadcast. Stubborn individuals can significantly affect the opinion dynamics and reduce evacuation rates. In addition, evacuation rates respond to the percentage of stubborn agents in a non-linear manner, i.e., above a threshold, the impact of stubborn agents will be intensified by stronger social media. These results highlight the role of social media in flood evacuation processes and the need to monitor social media so that misinformation can be corrected in a timely manner. The joint impacts of social media, quality of flood warnings and transportation capacity on evacuation rates are also discussed.

Pedestrian flow-path modeling to support tsunami evacuation and disaster relief planning in the U.S. Pacific Northwest

USGS Publications Warehouse

Wood, Nathan J.; Jones, Jeanne M.; Schmidtlein, Mathew; Schelling, John; Frazier, T.

2016-01-01

Successful evacuations are critical to saving lives from future tsunamis. Pedestrian-evacuation modeling related to tsunami hazards primarily has focused on identifying areas and the number of people in these areas where successful evacuations are unlikely. Less attention has been paid to identifying evacuation pathways and population demand at assembly areas for at-risk individuals that may have sufficient time to evacuate. We use the neighboring coastal communities of Hoquiam, Aberdeen, and Cosmopolis (Washington, USA) and the local tsunami threat posed by Cascadia subduction zone earthquakes as a case study to explore the use of geospatial, least-cost-distance evacuation modeling for supporting evacuation outreach, response, and relief planning. We demonstrate an approach that uses geospatial evacuation modeling to (a) map the minimum pedestrian travel speeds to safety, the most efficient paths, and collective evacuation basins, (b) estimate the total number and demographic description of evacuees at predetermined assembly areas, and (c) determine which paths may be compromised due to earthquake-induced ground failure. Results suggest a wide range in the magnitude and type of evacuees at predetermined assembly areas and highlight parts of the communities with no readily accessible assembly area. Earthquake-induced ground failures could obstruct access to some assembly areas, cause evacuees to reroute to get to other assembly areas, and isolate some evacuees from relief personnel. Evacuation-modeling methods and results discussed here have implications and application to tsunami-evacuation outreach, training, response procedures, mitigation, and long-term land use planning to increase community resilience.

External factors impacting hospital evacuations caused by Hurricane Rita: the role of situational awareness.

PubMed

Downey, Erin L; Andress, Knox; Schultz, Carl H

2013-06-01

The 2005 Gulf Coast hurricane season was one of the most costly and deadly in US history. Hurricane Rita stressed hospitals and led to multiple, simultaneous evacuations. This study systematically identified community factors associated with patient movement out of seven hospitals evacuated during Hurricane Rita. This study represents the second of two systematic, observational, and retrospective investigations of seven acute care hospitals that reported off-site evacuations due to Hurricane Rita. Participants from each hospital included decision makers that comprised the Incident Management Team (IMT). Investigators applied a standardized interview process designed to assess evacuation factors related to external situational awareness of community activities during facility evacuation due to hurricanes. The measured outcomes were responses to 95 questions within six sections of the survey instrument. Investigators identified two factors that significantly impacted hospital IMT decision making: (1) incident characteristics affecting a facility's internal resources and challenges; and (2) incident characteristics affecting a facility's external evacuation activities. This article summarizes the latter and reports the following critical decision making points: (1) Emergency Operations Plans (EOP) were activated an average of 85 hours (3 days, 13 hours) prior to Hurricane Rita's landfall; (2) the decision to evacuate the hospital was made an average of 30 hours (1 day, 6 hours) from activation of the EOP; and (3) the implementation of the evacuation process took an average of 22 hours. Coordination of patient evacuations was most complicated by transportation deficits (the most significant of the 11 identified problem areas) and a lack of situational awareness of community response activities. All evacuation activities and subsequent evacuation times were negatively impacted by an overall lack of understanding on the part of hospital staff and the IMT regarding how to identify and coordinate with community resources. Hospital evacuation requires coordinated processes and resources, including situational awareness that reflects the condition of the community as a result of the incident. Successful hospital evacuation decision making is influenced by community-wide situational awareness and transportation deficits. Planning with the community to create realistic EOPs that accurately reflect available resources and protocols is critical to informing hospital decision making during a crisis. Knowledge of these factors could improve decision making and evacuation practices, potentially reducing evacuation times in future hurricanes.

Ecological validity of virtual reality daily living activities screening for early dementia: longitudinal study.

PubMed

Tarnanas, Ioannis; Schlee, Winfried; Tsolaki, Magda; Müri, René; Mosimann, Urs; Nef, Tobias

2013-08-06

Dementia is a multifaceted disorder that impairs cognitive functions, such as memory, language, and executive functions necessary to plan, organize, and prioritize tasks required for goal-directed behaviors. In most cases, individuals with dementia experience difficulties interacting with physical and social environments. The purpose of this study was to establish ecological validity and initial construct validity of a fire evacuation Virtual Reality Day-Out Task (VR-DOT) environment based on performance profiles as a screening tool for early dementia. The objectives were (1) to examine the relationships among the performances of 3 groups of participants in the VR-DOT and traditional neuropsychological tests employed to assess executive functions, and (2) to compare the performance of participants with mild Alzheimer's-type dementia (AD) to those with amnestic single-domain mild cognitive impairment (MCI) and healthy controls in the VR-DOT and traditional neuropsychological tests used to assess executive functions. We hypothesized that the 2 cognitively impaired groups would have distinct performance profiles and show significantly impaired independent functioning in ADL compared to the healthy controls. The study population included 3 groups: 72 healthy control elderly participants, 65 amnestic MCI participants, and 68 mild AD participants. A natural user interface framework based on a fire evacuation VR-DOT environment was used for assessing physical and cognitive abilities of seniors over 3 years. VR-DOT focuses on the subtle errors and patterns in performing everyday activities and has the advantage of not depending on a subjective rating of an individual person. We further assessed functional capacity by both neuropsychological tests (including measures of attention, memory, working memory, executive functions, language, and depression). We also evaluated performance in finger tapping, grip strength, stride length, gait speed, and chair stands separately and while performing VR-DOTs in order to correlate performance in these measures with VR-DOTs because performance while navigating a virtual environment is a valid and reliable indicator of cognitive decline in elderly persons. The mild AD group was more impaired than the amnestic MCI group, and both were more impaired than healthy controls. The novel VR-DOT functional index correlated strongly with standard cognitive and functional measurements, such as mini-mental state examination (MMSE; rho=0.26, P=.01) and Bristol Activities of Daily Living (ADL) scale scores (rho=0.32, P=.001). Functional impairment is a defining characteristic of predementia and is partly dependent on the degree of cognitive impairment. The novel virtual reality measures of functional ability seem more sensitive to functional impairment than qualitative measures in predementia, thus accurately differentiating from healthy controls. We conclude that VR-DOT is an effective tool for discriminating predementia and mild AD from controls by detecting differences in terms of errors, omissions, and perseverations while measuring ADL functional ability.

Simulation of pedestrian crowds’ evacuation in a huge transit terminal subway station

NASA Astrophysics Data System (ADS)

Lei, Wenjun; Li, Angui; Gao, Ran; Hao, Xinpeng; Deng, Baoshun

2012-11-01

As modernized urban rail transportation, subways are playing an important role in transiting large passenger flows. Passengers are in high density within the subway during rush hours. The casualty and injury will be tremendous if an accident occurs, such as a fire. Hence, enough attention should be paid on pedestrian crowds’ evacuation in a subway. In this paper, simulation of the process of pedestrian crowds’ evacuation from a huge transit terminal subway station is conducted. The evacuation process in different cases is conducted by using an agent-based model. Effects of occupant density, exit width and automatic fare gates on evacuation time are studied in detail. It is found that, with the increase of the occupant density, the evacuation efficiency would decline. There is a linear relationship between occupant density and evacuation time. Different occupant densities correspond to different critical exit widths. However, the existence of the automatic fare gates has little effect on evacuation time and tendency. The current results of this study will be helpful in guiding evacuation designs of huge underground spaces.

Application of fire and evacuation models in evaluation of fire safety in railway tunnels

NASA Astrophysics Data System (ADS)

Cábová, Kamila; Apeltauer, Tomáš; Okřinová, Petra; Wald, František

2017-09-01

The paper describes an application of numerical simulation of fire dynamics and evacuation of people in a tunnel. The software tool Fire Dynamics Simulator is used to simulate temperature resolution and development of smoke in a railway tunnel. Comparing to temperature curves which are usually used in the design stage results of the model show that the numerical model gives lower temperature of hot smoke layer. Outputs of the numerical simulation of fire also enable to improve models of evacuation of people during fires in tunnels. In the presented study the calculated high of smoke layer in the tunnel is in 10 min after the fire ignition lower than the level of 2.2 m which is considered as the maximal limit for safe evacuation. Simulation of the evacuation process in bigger scale together with fire dynamics can provide very valuable information about important security conditions like Available Safe Evacuation Time (ASET) vs Required Safe Evacuation Time (RSET). On given example in software EXODUS the paper summarizes selected results of evacuation model which should be in mind of a designer when preparing an evacuation plan.

Ultra-Scale Computing for Emergency Evacuation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bhaduri, Budhendra L; Nutaro, James J; Liu, Cheng

2010-01-01

Emergency evacuations are carried out in anticipation of a disaster such as hurricane landfall or flooding, and in response to a disaster that strikes without a warning. Existing emergency evacuation modeling and simulation tools are primarily designed for evacuation planning and are of limited value in operational support for real time evacuation management. In order to align with desktop computing, these models reduce the data and computational complexities through simple approximations and representations of real network conditions and traffic behaviors, which rarely represent real-world scenarios. With the emergence of high resolution physiographic, demographic, and socioeconomic data and supercomputing platforms, itmore » is possible to develop micro-simulation based emergency evacuation models that can foster development of novel algorithms for human behavior and traffic assignments, and can simulate evacuation of millions of people over a large geographic area. However, such advances in evacuation modeling and simulations demand computational capacity beyond the desktop scales and can be supported by high performance computing platforms. This paper explores the motivation and feasibility of ultra-scale computing for increasing the speed of high resolution emergency evacuation simulations.« less

The herbal medicine daikenchuto ameliorates an impaired anorectal motor activity in postoperative pediatric patients with an anorectal malformation--a pilot study.

PubMed

Takagi, Akiko; Yagi, Minoru; Tanaka, Yoshiaki; Asagiri, Kimio; Asakawa, Takahiro; Tanaka, Hiroaki; Ishii, Shinji; Egami, Hideaki; Akaiwa, Masao; Tsuru, Tomomitsu

2010-01-01

Fecoflowmetry (FFM) has been introduced to simulate natural anorectal evacuation. So far, few reports have described the effect of the herbal medicine Daikenchuto (DKT) on impaired anorectal motor function. The aim of this pilot study was to assess anorectal motor function by FFM in postoperatively impaired patients with an anorectal malformation (ARM) before and after administration of DKT. Six postoperative patients with ARM (mean age, 7.8 years) who complained of intractable constipation with soiling in spite of administration of magnesia as a laxative were assessed over an extended period. These patients received 0.3 g/kg/d of DKT for an average of 128 days. Evacuative rate and maximum fecal stream flow were seen to increase significantly after administration of DKT when compared with values before administration of DKT. In conclusion, DKT had a favorable clinical effect on anorectal motor function in postoperative patients with ARM.

Fecoflowmetric Analysis of Anorectal Motor Function in Postoperative Anal-Preserving Surgery Patients With Low Rectal Cancer Comparison With the Wexner Score and Anorectal Manometry

PubMed Central

Ryu, Yasuhiko; Akagi, Yoshito; Yagi, Minoru; Sasatomi, Teruo; Kinugasa, Tetsushi; Yamaguchi, Keizo; Oka, Yousuke; Fukahori, Suguru; Shiratsuchi, Ichitaro; Yoshida, Takefumi; Gotanda, Yukito; Tanaka, Natsuki; Ohchi, Takafumi; Romeo, Kansakar; Shirouzu, Kazuo

2015-01-01

The aim of this study was to elucidate whether fecoflowmetry (FFM) could evaluate more detailed evacuative function than anorectal manometry by comparing between FFM or anorectal manometric findings and the clinical questionnaires and the types of surgical procedure in the patients who received anal-preserving surgery. Fifty-three patients who underwent anal-preserving surgery for low rectal cancer were enrolled. The relationships between FFM or the manometric findings and the clinical questionnaires and the types of procedure of anal-preserving surgery were evaluated. There were significant differences between FFM markers and the clinical questionnaire and the types of the surgical procedure, whereas no significant relationship was observed between the manometric findings and the clinical questionnaire and the types of the surgical procedure. FFM might be feasible and useful for the objective assessment of evacuative function and may be superior to manometry for patients undergoing anal-preserving surgery. PMID:25594637

Routes to effective evacuation planning primer series : evacuating populations with special needs.

DOT National Transportation Integrated Search

2009-04-01

Evacuation operations are conducted under the authority of, and based on decisions by, local and state authorities. The purpose of this primer, Evacuating Populations with Special Needs, is to provide local and state emergency managers, government of...

Evidence from dynamic integrated proctography to redefine anismus.

PubMed

Roberts, J P; Womack, N R; Hallan, R I; Thorpe, A C; Williams, N S

1992-11-01

The role of anismus in the aetiology of defective rectal evacuation was investigated by dynamic integrated proctography in 20 controls and 71 constipated patients. Normal parameters were defined and compared between 21 constipated patients with poor evacuation during proctography (< 40 per cent of contrast evacuated; group 1) and 50 who evacuated fully (> 90 per cent of contrast evacuated; group 2). Nine patients in group 1 failed to evacuate. Radiological abnormalities of the rectum were recorded in all groups but obstructed evacuation was not observed. Anismus (defined as a recruitment of puborectalis electromyogram (EMG) activity of > 50 per cent) was significantly more common in group 1 than group 2 patients (14 of 21 versus 12 of 50, P < 0.01) and present in seven of those unable to evacuate. Eight patients in group 1 failed to raise intrarectal pressure > 50 cmH2O compared with two in group 2 (P < 0.001). Six patients in group 1 demonstrated both anismus and inability to raise intrarectal pressure, which may combine to cause defective evacuation. EMG recruitment alone is insufficient to diagnose anismus. Definition should be based on three criteria: demonstration of puborectalis EMG recruitment of > 50 per cent; evidence of an adequate level of intrarectal pressure (> 50 cmH2O) on straining; and presence of defective evacuation.

Feasibility of negative pressure wound therapy during intercontinental aeromedical evacuation of combat casualties.

PubMed

Fang, Raymond; Dorlac, Warren C; Flaherty, Stephen F; Tuman, Caroline; Cain, Steven M; Popey, Tracy L C; Villard, Douglas R; Aydelotte, Jayson D; Dunne, James R; Anderson, Adam M; Powell, Elisha T

2010-07-01

The objective of this study was to assess the feasibility of utilizing negative pressure wound therapy (NPWT) for the treatment of wartime soft-tissue wounds during intercontinental aeromedical evacuation. Attempts to use NPWT during early phases of overseas contingency operations resulted in occasional vacuum system failures and potentially contributed to wound complications. These anecdotal episodes led to a perception that NPWT during aeromedical evacuation carried a high risk of wound complications and limited its use. As a result, NPWT was not frequently applied in the management of soft-tissue wounds before US casualty arrival in the continental United States (CONUS) for wounds sustained in the combat theaters. Concurrently, early NPWT on the traumatic wounds of host nation casualties not requiring aeromedical evacuation seemed to provide many benefits typically associated with the therapy such as decreased infection rates, earlier wound closure, and improved pain management. On a daily basis, study investigators reviewed the trauma in-patient census at Landstuhl Regional Medical Center, Germany, to identify patient candidates with soft-tissue extremity or torso wounds that required packing. Patient demographics, injuries, and previous wound treatments were recorded. Surgeons inspected wounds in the operating room and applied a NPWT dressing if deemed appropriate. NPWT was continued throughout the remainder of the patient's hospitalization and also during aeromedical evacuation to CONUS. A study investigator escorted the patient during aeromedical evacuation to educate the flight crews, to record the impact on crew workload, and to troubleshoot the system if necessary. Thirty enrolled patients with 41 separate wounds flew from Germany to CONUS with a portable NPWT system (VAC Freedom System; Kinetic Concepts Incorporated, San Antonio, TX). All 30 patients arrived at the destination facilities with intact and functional systems. No significant in-flight complications were identified, impact on flight crew workload was negligible, and subjective feedback from both flight crews and patients was uniformly positive. For 29 patients, the NPWT dressing was replaced (frequently with serial exchanges) during initial surgical treatment in CONUS; the 30th patient underwent delayed primary closure of his right forearm fasciotomy. Receiving care teams reported no complications attributable to NPWT during aeromedical evacuation. NPWT is feasible during intercontinental aeromedical evacuation of combat casualties without an increase in wound complications or a significant impact on air crew workload. Further studies are indicated to evaluate the efficacy of NPWT in combat wounds compared with other wound care techniques.

Evacuate or Shelter-in-place? The Role of Corporate Memory and Political Environment in Hospital-evacuation Decision Making.

PubMed

Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Kranke, Derrick; Dobalian, Aram

2015-06-01

Hospital-evacuation decisions are rarely straightforward in protracted advance-warning events. Previous work provides little insight into the decision-making process around evacuation. This study was conducted to identify factors that most heavily influenced the decisions to evacuate the US Department of Veterans Affairs (VA) New York Harbor Healthcare System's (NYHHS; New York USA) Manhattan Campus before Hurricane Irene in 2011 and before Superstorm Sandy in 2012. Semi-structured interviews with 11 senior leaders were conducted on the processes and factors that influenced the evacuation decisions prior to each event. The most influential factor in the decision to evacuate the Manhattan Campus before Hurricane Irene was New York City's (NYC's) hospital-evacuation mandate. As a federal facility, the Manhattan VA medical center (VAMC) was exempt from the city's order, but decision makers felt compelled to comply. In the case of Superstorm Sandy, corporate memory of a similar 1992 storm that crippled the Manhattan facility drove the decision to evacuate before the storm hit. Results suggest that hospital-evacuation decisions are confounded by political considerations and are influenced by past disaster experience. Greater shared situational awareness among at-risk hospitals, along with a more coordinated approach to evacuation decision making, could reduce pressure on hospitals to make these high-stakes decisions. Systematic mechanisms for collecting, documenting, and sharing lessons learned from past disasters are sorely needed at the institutional, local, and national levels.

21 CFR 876.4370 - Gastroenterology-urology evacuator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology evacuator. 876.4370... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4370 Gastroenterology-urology evacuator. (a) Identification. A gastroenterology-urology evacuator is a device used to remove...

NUclear EVacuation Analysis Code (NUEVAC) : a tool for evaluation of sheltering and evacuation responses following urban nuclear detonations.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoshimura, Ann S.; Brandt, Larry D.

2009-11-01

The NUclear EVacuation Analysis Code (NUEVAC) has been developed by Sandia National Laboratories to support the analysis of shelter-evacuate (S-E) strategies following an urban nuclear detonation. This tool can model a range of behaviors, including complex evacuation timing and path selection, as well as various sheltering or mixed evacuation and sheltering strategies. The calculations are based on externally generated, high resolution fallout deposition and plume data. Scenario setup and calculation outputs make extensive use of graphics and interactive features. This software is designed primarily to produce quantitative evaluations of nuclear detonation response options. However, the outputs have also proven usefulmore » in the communication of technical insights concerning shelter-evacuate tradeoffs to urban planning or response personnel.« less

Pedestrian Evacuation Analysis for Tsunami Hazards

NASA Astrophysics Data System (ADS)

Jones, J. M.; Ng, P.; Wood, N. J.

2014-12-01

Recent catastrophic tsunamis in the last decade, as well as the 50th anniversary of the 1964 Alaskan event, have heightened awareness of the threats these natural hazards present to large and increasing coastal populations. For communities located close to the earthquake epicenter that generated the tsunami, strong shaking may also cause significant infrastructure damage, impacting the road network and hampering evacuation. There may also be insufficient time between the earthquake and first wave arrival to rely on a coordinated evacuation, leaving at-risk populations to self-evacuate on foot and across the landscape. Emergency managers evaluating these coastal risks need tools to assess the evacuation potential of low-lying areas in order to discuss mitigation options, which may include vertical evacuation structures to provide local safe havens in vulnerable communities. The U.S. Geological Survey has developed the Pedestrian Evacuation Analyst software tool for use by researchers and emergency managers to assist in the assessment of a community's evacuation potential by modeling travel times across the landscape and producing both maps of travel times and charts of population counts with corresponding times. The tool uses an anisotropic (directionally dependent) least cost distance model to estimate evacuation potential and allows for the variation of travel speed to measure its effect on travel time. The effectiveness of vertical evacuation structures on evacuation time can also be evaluated and compared with metrics such as travel time maps showing each structure in place and graphs displaying the percentage change in population exposure for each structure against the baseline. Using the tool, travel time maps and at-risk population counts have been generated for some coastal communities of the U.S. Pacific Northwest and Alaska. The tool can also be used to provide valuable decision support for tsunami vertical evacuation siting.

Evacuation Priorities in Mass Casualty Terror-Related Events

PubMed Central

Einav, Sharon; Feigenberg, Zvi; Weissman, Charles; Zaichik, Daniel; Caspi, Guy; Kotler, Doron; Freund, Herbert R.

2004-01-01

Objective: To assess evacuation priorities during terror-related mass casualty incidents (MCIs) and their implications for hospital organization/contingency planning. Summary Background Data: Trauma guidelines recommend evacuation of critically injured patients to Level I trauma centers. The recent MCIs in Israel offered an opportunity to study the impositions placed on a prehospital emergency medical service (EMS) regarding evacuation priorities in these circumstances. Methods: A retrospective analysis of medical evacuations from MCIs (29.9.2000–31.9.2002) performed by the Israeli National EMS rescue teams. Results: Thirty-three MCIs yielded data on 1156 casualties. Only 57% (506) of the 1123 available and mobilized ambulances were needed to provide 612 evacuations. Rescue teams arrived on scene within <5 minutes and evacuated the last urgent casualty within 15–20 minutes. The majority of non-urgent and urgent patients were transported to medical centers close to the event. Less than half of the urgent casualties were evacuated to more distant trauma centers. Independent variables predicting evacuation to a trauma center were its being the hospital closest to the event (OR 249.2, P < 0.001), evacuation within <10 minutes of the event (OR 9.3, P = 0.003), and having an urgent patient on the ambulance (OR 5.6, P < 0.001). Conclusions: Hospitals nearby terror-induced MCIs play a major role in trauma patient care. Thus, all hospitals should be included in contingency plans for MCIs. Further research into the implications of evacuation of the most severely injured casualties to the nearest hospital while evacuating all other casualties to various hospitals in the area is needed. The challenges posed by terror-induced MCIs require consideration of a paradigm shift in trauma care. PMID:15075645

Decision Processes and Determinants of Hospital Evacuation and Shelter-in-Place During Hurricane Sandy.

PubMed

McGinty, Meghan D; Burke, Thomas A; Resnick, Beth; Barnett, Daniel J; Smith, Katherine C; Rutkow, Lainie

Evacuation and shelter-in-place decision making for hospitals is complex, and existing literature contains little information about how these decisions are made in practice. To describe decision-making processes and identify determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. Semistructured interviews were conducted from March 2014 to February 2015 with key informants who had authority and responsibility for evacuation and shelter-in-place decisions for hospitals during Hurricane Sandy in 2012. Interviews were recorded, transcribed, and thematically analyzed. Interviewees included hospital executives and state and local public health, emergency management, and emergency medical service officials from Delaware, Maryland, New Jersey, and New York. Interviewees identified decision processes and determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. We interviewed 42 individuals from 32 organizations. Decisions makers reported relying on their instincts rather than employing guides or tools to make evacuation and shelter-in-place decisions during Hurricane Sandy. Risk to patient health from evacuation, prior experience, cost, and ability to maintain continuity of operations were the most influential factors in decision making. Flooding and utility outages, which were predicted to or actually impacted continuity of operations, were the primary determinants of evacuation. Evacuation and shelter-in-place decision making for hospitals can be improved by ensuring hospital emergency plans address flooding and include explicit thresholds that, if exceeded, would trigger evacuation. Comparative risk assessments that inform decision making would be enhanced by improved collection, analysis, and communication of data on morbidity and mortality associated with evacuation versus sheltering-in-place of hospitals. In addition, administrators and public officials can improve their preparedness to make evacuation and shelter-in-place decisions by practicing the use of decision-making tools during training and exercises.

The relationships between family functioning and attachment orientations to post-traumatic stress symptoms among young adults who were evacuated from Gaza Strip settlements as adolescents.

PubMed

Zerach, Gadi; Tam, Elkanor

2016-01-01

This study examined post-traumatic stress disorder (PTSD) symptoms among young adults that were evicted from their residences in Gaza settlements ("Gush Katif") as adolescents and actively participated in the resistance events. Furthermore, we examined the moderating role of exposure to forced relocation on the association between attachment orientations and family functioning and PTSD symptoms. We conducted a correlative, cross-sectional study in 2013. Participants were Israeli evicted residents (ER group; N = 102), comparison groups of evicted nonresidents (ENR group; N = 27), and nonevicted nonresidents (NENR group; N = 53). All participants completed a battery of self-reported questionnaires. The ER group reported a higher number of PTSD symptoms as compared to the comparison groups. However, ER participants did not differ from ENR and NENR participants in their perception of family functioning. Importantly, the group (ER vs. NENR) moderated the association between attachment-anxiety and PTSD symptoms and between family adaptability and PTSD symptoms. Nine years after the forced relocation from Gaza settlements, young adults that were evicted from their residences as adolescents suffer from PTSD symptoms that are more related to the relocation itself than the stress entailed in the resistance events.

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... associated liferafts. Inflatable liferafts used in conjunction with the marine evacuation system must be stowed as follows: (1) Each inflatable liferaft used in conjunction with the marine evacuation system... platform. (2) Each inflatable liferaft used in conjunction with the marine evacuation system must be...

Modeling hurricane evacuation traffic : testing the gravity and intervening opportunity models as models of destination choice in hurricane evacuation.

DOT National Transportation Integrated Search

2008-03-01

The objectives of this study are to test whether the Gravity and Intervening Opportunity Models (IOM) can successfully reproduce aggregate evacuation destination choice observed in evacuation behavior from Hurricane Floyd, compare the performance of ...

A Method for Formulizing Disaster Evacuation Demand Curves Based on SI Model

PubMed Central

Song, Yulei; Yan, Xuedong

2016-01-01

The prediction of evacuation demand curves is a crucial step in the disaster evacuation plan making, which directly affects the performance of the disaster evacuation. In this paper, we discuss the factors influencing individual evacuation decision making (whether and when to leave) and summarize them into four kinds: individual characteristics, social influence, geographic location, and warning degree. In the view of social contagion of decision making, a method based on Susceptible-Infective (SI) model is proposed to formulize the disaster evacuation demand curves to address both social influence and other factors’ effects. The disaster event of the “Tianjin Explosions” is used as a case study to illustrate the modeling results influenced by the four factors and perform the sensitivity analyses of the key parameters of the model. Some interesting phenomena are found and discussed, which is meaningful for authorities to make specific evacuation plans. For example, due to the lower social influence in isolated communities, extra actions might be taken to accelerate evacuation process in those communities. PMID:27735875

Performance analysis of a solar still coupled with evacuated heat pipes

NASA Astrophysics Data System (ADS)

Pramod, B. V. N.; Prudhvi Raj, J.; Krishnan, S. S. Hari; Kotebavi, Vinod

2018-02-01

In developing countries the need for better quality drinking water is increasing steadily. We can overcome this need by using solar energy for desalination purpose. This process includes fabrication and analysis of a pyramid type solar still coupled with evacuated heat pipes. This experiment using evacuated heat pipes are carried in mainly three modes namely 1) Still alone 2) Using heat pipe with evacuated tubes 3)Using evacuated heat pipe. For this work single basin pyramid type solar still with 1m2 basin area is fabricated. Black stones and Black paint are utilised in solar still to increase evaporation rate of water in basin. The heat pipe’s evaporator section is placed inside evacuated tube and the heat pipe’s condenser section is connected directly to the pyramid type solar still’s lower portion. The output of distillate water from still with evacuated heat pipe is found to be 40% more than the still using only evacuated tubes.

Identification of Evacuation Routes in Tacloban City using Geographic Information System

NASA Astrophysics Data System (ADS)

Mendoza, Jerico; Mahar Francisco Lagmay, Alfredo; Santiago, Joy; Suarez, John Kenneth

2016-04-01

The Philippines is the second most at risk to natural hazards according to the 2014 World Risk Report. On 8 November 2013, category 5 Typhoon Haiyan crossed the central region of the Philippines with maximum sustained wind reaching 315 kph. Considered as one of the strongest typhoons that made landfall in recorded history, Typhoon Haiyan caused USD 8 billion damage to properties, 6,293 deaths, 28,689 injured and 1,061 missing persons. Tacloban City, located in the north-eastern part of the island of Leyte in Eastern Visayas region, is one of the area most devastated by Typhoon Haiyan. The city is susceptible to other natural hazards given its geography, topography and geology. This condition emphasizes the need for preventive measures to avoid further loss of lives and destruction to properties. Evacuation is a mitigating strategy which involves the process of moving people from dangerous places to safer locations. Using Geographic Information System (GIS), a multi-hazard map of Tacloban City was created to determine safe areas for evacuation centers. The optimal route for evacuation was identified using ArcGIS Network Analyst's routing solver based on Dijkstra's algorithm. The medium of transportation used in the analysis is by foot with an average speed of 5.0 kph. Furthermore, the study assumes that all roads are passable and fully functional during the travel period and that there are no structures, trees and other debris that may act as road blockage. The study can be used as a reference in hazard assessment for disaster risk management and evacuation planning. This can be further improved by incorporating behaviour of the affected population and other socio-economic factors, different modes of transportation and detailed analysis of topography.

Variations in population vulnerability to tectonic and landslide-related tsunami hazards in Alaska

USGS Publications Warehouse

Wood, Nathan J.; Peters, Jeff

2015-01-01

Effective tsunami risk reduction requires an understanding of how at-risk populations are specifically vulnerable to tsunami threats. Vulnerability assessments primarily have been based on single hazard zones, even though a coastal community may be threatened by multiple tsunami sources that vary locally in terms of inundation extents and wave arrival times. We use the Alaskan coastal communities of Cordova, Kodiak, Seward, Valdez, and Whittier (USA), as a case study to explore population vulnerability to multiple tsunami threats. We use anisotropic pedestrian evacuation models to assess variations in population exposure as a function of travel time out of hazard zones associated with tectonic and landslide-related tsunamis (based on scenarios similar to the 1964 M w9.2 Good Friday earthquake and tsunami disaster). Results demonstrate that there are thousands of residents, employees, and business customers in tsunami hazard zones associated with tectonically generated waves, but that at-risk individuals will likely have sufficient time to evacuate to high ground before waves are estimated to arrive 30–60 min after generation. Tsunami hazard zones associated with submarine landslides initiated by a subduction zone earthquake are smaller and contain fewer people, but many at-risk individuals may not have enough time to evacuate as waves are estimated to arrive in 1–2 min and evacuations may need to occur during earthquake ground shaking. For all hazard zones, employees and customers at businesses far outnumber residents at their homes and evacuation travel times are highest on docks and along waterfronts. Results suggest that population vulnerability studies related to tsunami hazards should recognize non-residential populations and differences in wave arrival times if emergency managers are to develop realistic preparedness and outreach efforts.

Modeling and assessment of civil aircraft evacuation based on finer-grid

NASA Astrophysics Data System (ADS)

Fang, Zhi-Ming; Lv, Wei; Jiang, Li-Xue; Xu, Qing-Feng; Song, Wei-Guo

2016-04-01

Studying civil aircraft emergency evacuation process by using computer model is an effective way. In this study, the evacuation of Airbus A380 is simulated using a Finer-Grid Civil Aircraft Evacuation (FGCAE) model. In this model, the effect of seat area and others on escape process and pedestrian's "hesitation" before leaving exits are considered, and an optimized rule of exit choice is defined. Simulations reproduce typical characteristics of aircraft evacuation, such as the movement synchronization between adjacent pedestrians, route choice and so on, and indicate that evacuation efficiency will be determined by pedestrian's "preference" and "hesitation". Based on the model, an assessment procedure of aircraft evacuation safety is presented. The assessment and comparison with the actual evacuation test demonstrate that the available exit setting of "one exit from each exit pair" used by practical demonstration test is not the worst scenario. The half exits of one end of the cabin are all unavailable is the worst one, that should be paid more attention to, and even be adopted in the certification test. The model and method presented in this study could be useful for assessing, validating and improving the evacuation performance of aircraft.

Occurrence of depressive tendency and associated social factors among elderly persons forced by the Great East Japan Earthquake and nuclear disaster to live as long-term evacuees: a prospective cohort study.

PubMed

Kuroda, Yujiro; Iwasa, Hajime; Goto, Aya; Yoshida, Kazuki; Matsuda, Kumiko; Iwamitsu, Yumi; Yasumura, Seiji

2017-09-03

This study examined the incidence of depression and associated factors among elderly persons from Iitate village after the March 2011 earthquake. This was a prospective cohort study. As a baseline survey, in May 2010 a self-assessment Basic Checklist (BCL) was distributed to 1611 elderly villagers, of which 1277 responded. Of these respondents, 885 without a tendency to depression (69.3%) were given a follow-up survey in May 2013. The BCL was used to assess depression tendency, instrumental activities of daily living (IADL), physical function, nutritional status, oral function, homeboundness, cognitive function and social activities. Univariate analysis was used to examine differences in risk between those with a presence of depression tendency (PDT) and those without (non-PDT) depending on demographic and BCL variables. Variables found to be significant were analysed by Poisson regression analysis. Of the 438 respondents in the second survey, 163 (37.2%) showed depression tendency. PDT risk was significantly increased by female gender, age, history of diabetes and cognitive disorder. It was significantly reduced by increased IADL. Engagement in social activities decreased PDT risk in rental accommodation. Renters faced a higher risk of PDT than persons evacuated in groups to purpose-built housing. The inclusion of social activities in the multivariate Poisson regression analysis weakened this effect. Female gender, a history of diabetes, reduced IADL and a tendency to cognitive disorder each independently affected PDT risk. These findings may inform future responses to earthquakes and the technical disasters that may accompany them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

48 CFR 752.228-70 - Medical Evacuation (MEDEVAC) Services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Medical Evacuation... Clauses 752.228-70 Medical Evacuation (MEDEVAC) Services. As prescribed in 728.307-70, for use in all contracts requiring performance overseas: Medical Evacuation (MEDEVAC) Services (JUL 2007) (a) Contractor...

48 CFR 752.228-70 - Medical Evacuation (MEDEVAC) Services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Medical Evacuation... Clauses 752.228-70 Medical Evacuation (MEDEVAC) Services. As prescribed in 728.307-70, for use in all contracts requiring performance overseas: Medical Evacuation (MEDEVAC) Services (JUL 2007) (a) Contractor...

48 CFR 752.228-70 - Medical Evacuation (MEDEVAC) Services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Medical Evacuation... Clauses 752.228-70 Medical Evacuation (MEDEVAC) Services. As prescribed in 728.307-70, for use in all contracts requiring performance overseas: Medical Evacuation (MEDEVAC) Services (JUL 2007) (a) Contractor...

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Marine evacuation system launching arrangements. 108.545... DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.545 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each...

46 CFR 116.520 - Emergency evacuation plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Emergency evacuation plan. 116.520 Section 116.520... ARRANGEMENT Escape and Embarkation Station Requirements § 116.520 Emergency evacuation plan. The owner or managing operator shall prepare an evacuation plan that must: (a) Identify possible casualties involving...

46 CFR 116.520 - Emergency evacuation plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Emergency evacuation plan. 116.520 Section 116.520... ARRANGEMENT Escape and Embarkation Station Requirements § 116.520 Emergency evacuation plan. The owner or managing operator shall prepare an evacuation plan that must: (a) Identify possible casualties involving...

46 CFR 116.520 - Emergency evacuation plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Emergency evacuation plan. 116.520 Section 116.520... ARRANGEMENT Escape and Embarkation Station Requirements § 116.520 Emergency evacuation plan. The owner or managing operator shall prepare an evacuation plan that must: (a) Identify possible casualties involving...

46 CFR 116.520 - Emergency evacuation plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Emergency evacuation plan. 116.520 Section 116.520... ARRANGEMENT Escape and Embarkation Station Requirements § 116.520 Emergency evacuation plan. The owner or managing operator shall prepare an evacuation plan that must: (a) Identify possible casualties involving...

An Evaluation of Infrastructure for Tsunami Evacuation in Padang, West Sumatra, Indonesia (Invited)

NASA Astrophysics Data System (ADS)

Cedillos, V.; Canney, N.; Deierlein, G.; Diposaptono, S.; Geist, E. L.; Henderson, S.; Ismail, F.; Jachowski, N.; McAdoo, B. G.; Muhari, A.; Natawidjaja, D. H.; Sieh, K. E.; Toth, J.; Tucker, B. E.; Wood, K.

2009-12-01

Padang has one of the world’s highest tsunami risks due to its high hazard, vulnerable terrain and population density. The current strategy to prepare for tsunamis in Padang is focused on developing early warning systems, planning evacuation routes, conducting evacuation drills, and raising local awareness. Although these are all necessary, they are insufficient. Padang’s proximity to the Sunda Trench and flat terrain make reaching safe ground impossible for much of the population. The natural warning in Padang - a strong earthquake that lasts over a minute - will be the first indicator of a potential tsunami. People will have about 30 minutes after the earthquake to reach safe ground. It is estimated that roughly 50,000 people in Padang will be unable to evacuate in that time. Given these conditions, other means to prepare for the expected tsunami must be developed. With this motivation, GeoHazards International and Stanford University’s Chapter of Engineers for a Sustainable World partnered with Indonesian organizations - Andalas University and Tsunami Alert Community in Padang, Laboratory for Earth Hazards, and the Ministry of Marine Affairs and Fisheries - in an effort to evaluate the need for and feasibility of tsunami evacuation infrastructure in Padang. Tsunami evacuation infrastructure can include earthquake-resistant bridges and evacuation structures that rise above the maximum tsunami water level, and can withstand the expected earthquake and tsunami forces. The choices for evacuation structures vary widely - new and existing buildings, evacuation towers, soil berms, elevated highways and pedestrian overpasses. This interdisciplinary project conducted a course at Stanford University, undertook several field investigations, and concluded that: (1) tsunami evacuation structures and bridges are essential to protect the people in Padang, (2) there is a need for a more thorough engineering-based evaluation than conducted to-date of the suitability of existing buildings to serve as evacuation structures, and of existing bridges to serve as elements of evacuation routes, and (3) additions to Padang’s tsunami evacuation infrastructure must carefully take into account technical matters (e.g. expected wave height, debris impact forces), social considerations (e.g. cultural acceptability, public’s confidence in the structure’s integrity), and political issues (e.g. land availability, cost, maintenance). Future plans include collaboration between U.S. and Indonesian engineers in developing designs for new tsunami evacuation structures, as well as providing training for Indonesian authorities on: (1) siting, designing, and constructing tsunami evacuation structures, and (2) evaluating the suitability of existing buildings to serve as tsunami evacuation shelters.

Spatial memory enhances the evacuation efficiency of virtual pedestrians under poor visibility condition

NASA Astrophysics Data System (ADS)

Ma, Yi; Lee, Eric Wai Ming; Shi, Meng; Kwok Kit Yuen, Richard

2018-03-01

Spatial memory is a critical navigation support tool for disoriented evacuees during evacuation under adverse environmental conditions such as dark or smoky conditions. Owing to the complexity of memory, it is challenging to understand the effect of spatial memory on pedestrian evacuation quantitatively. In this study, we propose a simple method to quantitatively represent the evacueeʼs spatial memory about the emergency exit, model the evacuation of pedestrians under the guidance of the spatial memory, and investigate the effect of the evacueeʼs spatial memory on the evacuation from theoretical and physical perspectives. The result shows that (i) a good memory can significantly assist the evacuation of pedestrians under poor visibility conditions, and the evacuation can always succeed when the degree of the memory exceeds a threshold (\\varphi > 0.5); (ii) the effect of memory is superior to that of “follow-the-crowd” under the same environmental conditions; (iii) in the case of multiple exits, the difference in the degree of the memory between evacuees has a significant effect (the greater the difference, the faster the evacuation) for the evacuation under poor visibility conditions. Our study provides a new quantitative insight into the effect of spatial memory on crowd evacuation under poor visibility conditions. Project supported by the Research Grants Council of the Hong Kong Special Administrative Region, China (Grant No. 11203615).

Measuring and Modeling Behavioral Decision Dynamics in Collective Evacuation

PubMed Central

Carlson, Jean M.; Alderson, David L.; Stromberg, Sean P.; Bassett, Danielle S.; Craparo, Emily M.; Guiterrez-Villarreal, Francisco; Otani, Thomas

2014-01-01

Identifying and quantifying factors influencing human decision making remains an outstanding challenge, impacting the performance and predictability of social and technological systems. In many cases, system failures are traced to human factors including congestion, overload, miscommunication, and delays. Here we report results of a behavioral network science experiment, targeting decision making in a natural disaster. In a controlled laboratory setting, our results quantify several key factors influencing individual evacuation decision making in a controlled laboratory setting. The experiment includes tensions between broadcast and peer-to-peer information, and contrasts the effects of temporal urgency associated with the imminence of the disaster and the effects of limited shelter capacity for evacuees. Based on empirical measurements of the cumulative rate of evacuations as a function of the instantaneous disaster likelihood, we develop a quantitative model for decision making that captures remarkably well the main features of observed collective behavior across many different scenarios. Moreover, this model captures the sensitivity of individual- and population-level decision behaviors to external pressures, and systematic deviations from the model provide meaningful estimates of variability in the collective response. Identification of robust methods for quantifying human decisions in the face of risk has implications for policy in disasters and other threat scenarios, specifically the development and testing of robust strategies for training and control of evacuations that account for human behavior and network topologies. PMID:24520331

Impacts of high resolution data on traveler compliance levels in emergency evacuation simulations

DOE PAGES

Lu, Wei; Han, Lee D.; Liu, Cheng; ...

2016-05-05

In this article, we conducted a comparison study of evacuation assignment based on Traffic Analysis Zones (TAZ) and high resolution LandScan USA Population Cells (LPC) with detailed real world roads network. A platform for evacuation modeling built on high resolution population distribution data and activity-based microscopic traffic simulation was proposed. This platform can be extended to any cities in the world. The results indicated that evacuee compliance behavior affects evacuation efficiency with traditional TAZ assignment, but it did not significantly compromise the performance with high resolution LPC assignment. The TAZ assignment also underestimated the real travel time during evacuation. Thismore » suggests that high data resolution can improve the accuracy of traffic modeling and simulation. The evacuation manager should consider more diverse assignment during emergency evacuation to avoid congestions.« less

Population evacuations in industrial accidents: a review of the literature about four major events.

PubMed

Soffer, Yechiel; Schwartz, Dagan; Goldberg, Avishay; Henenfeld, Maxim; Bar-Dayan, Yaron

2008-01-01

This article reviews the literature describing four chemical and nuclear accidents and the lessons learned from each regarding the evacuation of civilian populations. Evacuation may save lives however, if poorly orchestrated, it may cause serious problems. For example, an inaccurate assessment of danger may lead to the evacuation of the same population twice, as the area requiring evacuation becomes larger than originally expected. Evacuation programs should focus on the vulnerable components of the populations, such as the elderly, children, and the disabled, and also should include plans for the care of pets and other animals. Training programs for civilians living near industrial centers and other high-risk areas should be considered. Finally, pre-event planning and preparation can improve the evacuation process and prevent panic behavior, and thus result in fewer casualties.

Who evacuates when hurricanes approach? The role of risk, information, and location.

PubMed

Stein, Robert M; Dueñas-Osorio, Leonardo; Subramanian, Devika

2010-01-01

This article offers an expanded perspective on evacuation decision making during severe weather. In particular, this work focuses on uncovering determinants of individual evacuation decisions. We draw on a survey conducted in 2005 of residents in the eight-county Houston metropolitan area after Hurricane Rita made landfall on September 24, 2005. We find that evacuation decisions are influenced by a heterogeneous set of parameters, including perceived risk from wind, influence of media and neighbors, and awareness of evacuation zone, that are often at variance with one of the primary measures of risk used by public officials to order or recommend an evacuation (i.e., storm surge). We further find that perceived risk and its influence on evacuation behavior is a local phenomenon more readily communicated by and among individuals who share the same geography, as is the case with residents living inside and outside official risk areas. Who evacuates and why is partially dependent on where one lives because perceptions of risk are not uniformly shared across the area threatened by an approaching hurricane and the same sources and content of information do not have the same effect on evacuation behavior. Hence, efforts to persuade residential populations about risk and when, where, and how to evacuate or shelter in place should originate in the neighborhood rather than emanating from blanket statements from the media or public officials. Our findings also raise important policy questions (included in the discussion section) that require further study and consideration by those responsible with organizing and implementing evacuation plans.

Sensitivity of tsunami evacuation modeling to direction and land cover assumptions

USGS Publications Warehouse

Schmidtlein, Mathew C.; Wood, Nathan J.

2015-01-01

Although anisotropic least-cost-distance (LCD) modeling is becoming a common tool for estimating pedestrian-evacuation travel times out of tsunami hazard zones, there has been insufficient attention paid to understanding model sensitivity behind the estimates. To support tsunami risk-reduction planning, we explore two aspects of LCD modeling as it applies to pedestrian evacuations and use the coastal community of Seward, Alaska, as our case study. First, we explore the sensitivity of modeling to the direction of movement by comparing standard safety-to-hazard evacuation times to hazard-to-safety evacuation times for a sample of 3985 points in Seward's tsunami-hazard zone. Safety-to-hazard evacuation times slightly overestimated hazard-to-safety evacuation times but the strong relationship to the hazard-to-safety evacuation times, slightly conservative bias, and shorter processing times of the safety-to-hazard approach make it the preferred approach. Second, we explore how variations in land cover speed conservation values (SCVs) influence model performance using a Monte Carlo approach with one thousand sets of land cover SCVs. The LCD model was relatively robust to changes in land cover SCVs with the magnitude of local model sensitivity greatest in areas with higher evacuation times or with wetland or shore land cover types, where model results may slightly underestimate travel times. This study demonstrates that emergency managers should be concerned not only with populations in locations with evacuation times greater than wave arrival times, but also with populations with evacuation times lower than but close to expected wave arrival times, particularly if they are required to cross wetlands or beaches.

30 CFR 57.4361 - Underground evacuation drills.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Underground evacuation drills. 57.4361 Section... Prevention and Control Firefighting Procedures/alarms/drills § 57.4361 Underground evacuation drills. (a) At least once every six months, mine evacuation drills shall be held to assess the ability of all persons...

30 CFR 57.4361 - Underground evacuation drills.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Underground evacuation drills. 57.4361 Section... Prevention and Control Firefighting Procedures/alarms/drills § 57.4361 Underground evacuation drills. (a) At least once every six months, mine evacuation drills shall be held to assess the ability of all persons...

30 CFR 57.4361 - Underground evacuation drills.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Underground evacuation drills. 57.4361 Section... Prevention and Control Firefighting Procedures/alarms/drills § 57.4361 Underground evacuation drills. (a) At least once every six months, mine evacuation drills shall be held to assess the ability of all persons...

30 CFR 57.4361 - Underground evacuation drills.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Underground evacuation drills. 57.4361 Section... Prevention and Control Firefighting Procedures/alarms/drills § 57.4361 Underground evacuation drills. (a) At least once every six months, mine evacuation drills shall be held to assess the ability of all persons...

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... liferafts. Inflatable liferafts used in conjunction with the marine evacuation system must be stowed as follows: (1) Each inflatable liferaft used in conjunction with the marine evacuation system must be close.... (2) Each inflatable liferaft used in conjunction with the marine evacuation system must be capable of...

75 FR 49507 - Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

...] Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations AGENCY: Federal Emergency... Management Agency (FEMA) is accepting comments on RP9525.4, Emergency Medical Care and Medical Evacuations... emergency medical care and medical evacuation expenses that are eligible for reimbursement under the...

POSTTRAUMATIC STRESS DISORDER AMONG INDONESIAN CHILDREN 5 YEARS AFTER THE TSUNAMI.

PubMed

Irwanto; Faisal; Zulfa, Hendra

2015-09-01

Children are at risk for developing posttraumatic stress disorder (PTSD) due to experiencing or living in a disaster area. The factors that increase the likelihood of a child developing PTSD need further clarification. We studied the factors associated with PTSD among children who experienced the tsunami in Sumatra, Indonesia. We conducted a cross sectional study in 2 subdistricts of Sumatra 5 years after experiencing a tsunami. Children aged 7-13 years were enrolled using stratified cluster sampling. A tsunami-modified version of The PsySTART Rapid Triage System was used to question children about their tsunami-specific traumatic experiences. Trauma symptoms were evaluated using the Trauma Symptom Checklist For Children (TSCC). The diagnosis of PTSD was made using the Child PTSD Symptom Scale (CPSS) and DSM-IV criteria. The data were analyzed with chi-square tests and multivariate logistic regression analysis with 95% confidence intervals (CI). A total of 262 children were enrolled in this study. The prevalence of PTSD in these children was 20.6%. On multivariate analysis, having experienced a delay in evacuation (PR = 4.5; 95% CI: 2.794-13.80; p < 0.001) and being unable to escape (PR = 13.07; 95% CI: 5.884-64; p < 0.001) were significantly associated with PTSD 5 years after the tsunami. Children who experienced a traumatic event in which they were unable to escape or when there is a delay in evacuation are at risk of developing PTSD and need appropriate treatment.

An optimization design for evacuation planning based on fuzzy credibility theory and genetic algorithm

NASA Astrophysics Data System (ADS)

Zhang, D.; Zhang, W. Y.

2017-08-01

Evacuation planning is an important activity in disaster management. It has to be planned in advance due to the unpredictable occurrence of disasters. It is necessary that the evacuation plans are as close as possible to the real evacuation work. However, the evacuation plan is extremely challenging because of the inherent uncertainty of the required information. There is a kind of vehicle routing problem based on the public traffic evacuation. In this paper, the demand for each evacuation set point is a fuzzy number, and each routing selection of the point is based on the fuzzy credibility preference index. This paper proposes an approximate optimal solution for this problem by the genetic algorithm based on the fuzzy reliability theory. Finally, the algorithm is applied to an optimization model, and the experiment result shows that the algorithm is effective.

Developing a database for pedestrians' earthquake emergency evacuation in indoor scenarios.

PubMed

Zhou, Junxue; Li, Sha; Nie, Gaozhong; Fan, Xiwei; Tan, Jinxian; Li, Huayue; Pang, Xiaoke

2018-01-01

With the booming development of evacuation simulation software, developing an extensive database in indoor scenarios for evacuation models is imperative. In this paper, we conduct a qualitative and quantitative analysis of the collected videotapes and aim to provide a complete and unitary database of pedestrians' earthquake emergency response behaviors in indoor scenarios, including human-environment interactions. Using the qualitative analysis method, we extract keyword groups and keywords that code the response modes of pedestrians and construct a general decision flowchart using chronological organization. Using the quantitative analysis method, we analyze data on the delay time, evacuation speed, evacuation route and emergency exit choices. Furthermore, we study the effect of classroom layout on emergency evacuation. The database for indoor scenarios provides reliable input parameters and allows the construction of real and effective constraints for use in software and mathematical models. The database can also be used to validate the accuracy of evacuation models.

Traffic evacuation time under nonhomogeneous conditions.

PubMed

Fazio, Joseph; Shetkar, Rohan; Mathew, Tom V

2017-06-01

During many manmade and natural crises such as terrorist threats, floods, hazardous chemical and gas leaks, emergency personnel need to estimate the time in which people can evacuate from the affected urban area. Knowing an estimated evacuation time for a given crisis, emergency personnel can plan and prepare accordingly with the understanding that the actual evacuation time will take longer. Given the urban area to be evacuated, street widths exiting the area's perimeter, the area's population density, average vehicle occupancy, transport mode share and crawl speed, an estimation of traffic evacuation time can be derived. Peak-hour traffic data collected at three, midblock, Mumbai sites of varying geometric features and traffic composition were used in calibrating a model that estimates peak-hour traffic flow rates. Model validation revealed a correlation coefficient of +0.98 between observed and predicted peak-hour flow rates. A methodology is developed that estimates traffic evacuation time using the model.

Global Optimization of Emergency Evacuation Assignments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, Lee; Yuan, Fang; Chin, Shih-Miao

2006-01-01

Conventional emergency evacuation plans often assign evacuees to fixed routes or destinations based mainly on geographic proximity. Such approaches can be inefficient if the roads are congested, blocked, or otherwise dangerous because of the emergency. By not constraining evacuees to prespecified destinations, a one-destination evacuation approach provides flexibility in the optimization process. We present a framework for the simultaneous optimization of evacuation-traffic distribution and assignment. Based on the one-destination evacuation concept, we can obtain the optimal destination and route assignment by solving a one-destination traffic-assignment problem on a modified network representation. In a county-wide, large-scale evacuation case study, the one-destinationmore » model yields substantial improvement over the conventional approach, with the overall evacuation time reduced by more than 60 percent. More importantly, emergency planners can easily implement this framework by instructing evacuees to go to destinations that the one-destination optimization process selects.« less

Remote Sensing Decision Support System for Optimal Access Restoration in Post Disaster Environments

DOT National Transportation Integrated Search

2017-01-01

Access restoration is an extremely important part of disaster response. Without access to the site, critically important emergency functions like search and rescue, emergency evacuation, and relief distribution, cannot commence. Frequently, roads are...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

Tsunami evacuation modelling as a tool for risk reduction: application to the coastal area of El Salvador

NASA Astrophysics Data System (ADS)

González-Riancho, P.; Aguirre-Ayerbe, I.; Aniel-Quiroga, I.; Abad, S.; González, M.; Larreynaga, J.; Gavidia, F.; Gutiérrez, O. Q.; Álvarez-Gómez, J. A.; Medina, R.

2013-12-01

Advances in the understanding and prediction of tsunami impacts allow the development of risk reduction strategies for tsunami-prone areas. This paper presents an integral framework for the formulation of tsunami evacuation plans based on tsunami vulnerability assessment and evacuation modelling. This framework considers (i) the hazard aspects (tsunami flooding characteristics and arrival time), (ii) the characteristics of the exposed area (people, shelters and road network), (iii) the current tsunami warning procedures and timing, (iv) the time needed to evacuate the population, and (v) the identification of measures to improve the evacuation process. The proposed methodological framework aims to bridge between risk assessment and risk management in terms of tsunami evacuation, as it allows for an estimation of the degree of evacuation success of specific management options, as well as for the classification and prioritization of the gathered information, in order to formulate an optimal evacuation plan. The framework has been applied to the El Salvador case study, demonstrating its applicability to site-specific response times and population characteristics.

Agent-based Large-Scale Emergency Evacuation Using Real-Time Open Government Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lu, Wei; Liu, Cheng; Bhaduri, Budhendra L

The open government initiatives have provided tremendous data resources for the transportation system and emergency services in urban areas. This paper proposes a traffic simulation framework using high temporal resolution demographic data and real time open government data for evacuation planning and operation. A comparison study using real-world data in Seattle, Washington is conducted to evaluate the framework accuracy and evacuation efficiency. The successful simulations of selected area prove the concept to take advantage open government data, open source data, and high resolution demographic data in emergency management domain. There are two aspects of parameters considered in this study: usermore » equilibrium (UE) conditions of traffic assignment model (simple Non-UE vs. iterative UE) and data temporal resolution (Daytime vs. Nighttime). Evacuation arrival rate, average travel time, and computation time are adopted as Measure of Effectiveness (MOE) for evacuation performance analysis. The temporal resolution of demographic data has significant impacts on urban transportation dynamics during evacuation scenarios. Better evacuation performance estimation can be approached by integrating both Non-UE and UE scenarios. The new framework shows flexibility in implementing different evacuation strategies and accuracy in evacuation performance. The use of this framework can be explored to day-to-day traffic assignment to support daily traffic operations.« less

Societal acceptance of unnecessary evacuation

NASA Astrophysics Data System (ADS)

McCaughey, Jamie W.; Mundzir, Ibnu; Patt, Anthony; Rosemary, Rizanna; Safrina, Lely; Mahdi, Saiful; Daly, Patrick

2017-04-01

Uncertainties in forecasting extreme events force an unavoidable tradeoff between false alarms and misses. The appropriate balance depends on the level of societal acceptance of unnecessary evacuations, but there has been little empirical research on this. Intuitively it may seem that an unnecessary evacuation would make people less likely to evacuate again in the future, but our study finds no support for this intuition. Using new quantitative (n=800) and qualitative evidence, we examine individual- and household-level evacuation decisions in response to the strong 11-Apr-2012 earthquake in Aceh, Indonesia. This earthquake did not produce a tsunami, but the population had previously experienced the devastating 2004 tsunami. In our sample, the vast majority of people (86%) evacuated in the 2012 earthquake, and nearly all (94%) say they would evacuate again if a similar earthquake happened in the future. Self-reported level of fear at the moment of the 2012 earthquake explains more of the variance in evacuation decisions and intentions than does a combination of perceived tsunami risk and perceived efficacy of evacuation modeled on protection motivation theory. These findings suggest that the appropriate balance between false alarms and misses may be highly context-specific. Investigating this in each context would make an important contribution to the effectiveness of early-warning systems.

Incorporating topography in a cellular automata model to simulate residents evacuation in a mountain area in China

NASA Astrophysics Data System (ADS)

Wang, Li; Liu, Mao; Meng, Bo

2013-02-01

In China, both the mountainous areas and the number of people who live in mountain areas occupy a significant proportion. When production accidents or natural disasters happen, the residents in mountain areas should be evacuated and the evacuation is of obvious importance to public safety. But it is a pity that there are few studies on safety evacuation in rough terrain. The particularity of the complex terrain in mountain areas, however, makes it difficult to study pedestrian evacuation. In this paper, a three-dimensional surface cellular automata model is proposed to numerically simulate the real time dynamic evacuation of residents. The model takes into account topographic characteristics (the slope gradient) of the environment and the biomechanics characteristics (weight and leg extensor power) of the residents to calculate the walking speed. This paper only focuses on the influence of topography and the physiological parameters are defined as constants according to a statistical report. Velocity varies with the topography. In order to simulate the behavior of a crowd with varying movement velocities, and a numerical algorithm is used to determine the time step of iteration. By doing so, a numerical simulation can be conducted in a 3D surface CA model. Moreover, considering residents evacuation around a gas well in a mountain area as a case, a visualization system for a three-dimensional simulation of pedestrian evacuation is developed. In the simulation process, population behaviors of congestion, queuing and collision avoidance can be observed. The simulation results are explained reasonably. Therefore, the model presented in this paper can realize a 3D dynamic simulation of pedestrian evacuation vividly in complex terrain and predict the evacuation procedure and evacuation time required, which can supply some valuable information for emergency management.

A Study of Flood Evacuation Center Using GIS and Remote Sensing Technique

NASA Astrophysics Data System (ADS)

Mustaffa, A. A.; Rosli, M. F.; Abustan, M. S.; Adib, R.; Rosli, M. I.; Masiri, K.; Saifullizan, B.

2016-07-01

This research demonstrated the use of Remote Sensing technique and GIS to determine the suitability of an evacuation center. This study was conducted in Batu Pahat areas that always hit by a series of flood. The data of Digital Elevation Model (DEM) was obtained by ASTER database that has been used to delineate extract contour line and elevation. Landsat 8 image was used for classification purposes such as land use map. Remote Sensing incorporate with GIS techniques was used to determined the suitability location of the evacuation center from contour map of flood affected areas in Batu Pahat. GIS will calculate the elevation of the area and information about the country of the area, the road access and percentage of the affected area. The flood affected area map may provide the suitability of the flood evacuation center during the several levels of flood. The suitability of evacuation centers can be determined based on several criteria and the existing data of the evacuation center will be analysed. From the analysis among 16 evacuation center listed, there are only 8 evacuation center suitable for the usage during emergency situation. The suitability analysis was based on the location and the road access of the evacuation center toward the flood affected area. There are 10 new locations with suitable criteria of evacuation center proposed on the study area to facilitate the process of rescue and evacuating flood victims to much safer and suitable locations. The results of this study will help in decision making processes and indirectly will help organization such as fire-fighter and the Department of Social Welfare in their work. Thus, this study can contribute more towards the society.

Beat-the-wave evacuation mapping for tsunami hazards in Seaside, Oregon, USA

USGS Publications Warehouse

Priest, George R.; Stimely, Laura; Wood, Nathan J.; Madin, Ian; Watzig, Rudie

2016-01-01

Previous pedestrian evacuation modeling for tsunamis has not considered variable wave arrival times or critical junctures (e.g., bridges), nor does it effectively communicate multiple evacuee travel speeds. We summarize an approach that identifies evacuation corridors, recognizes variable wave arrival times, and produces a map of minimum pedestrian travel speeds to reach safety, termed a “beat-the-wave” (BTW) evacuation analysis. We demonstrate the improved approach by evaluating difficulty of pedestrian evacuation of Seaside, Oregon, for a local tsunami generated by a Cascadia subduction zone earthquake. We establish evacuation paths by calculating the least cost distance (LCD) to safety for every grid cell in a tsunami-hazard zone using geospatial, anisotropic path distance algorithms. Minimum BTW speed to safety on LCD paths is calculated for every grid cell by dividing surface distance from that cell to safety by the tsunami arrival time at safety. We evaluated three scenarios of evacuation difficulty: (1) all bridges are intact with a 5-minute evacuation delay from the start of earthquake, (2) only retrofitted bridges are considered intact with a 5-minute delay, and (3) only retrofitted bridges are considered intact with a 10-minute delay. BTW maps also take into account critical evacuation points along complex shorelines (e.g., peninsulas, bridges over shore-parallel estuaries) where evacuees could be caught by tsunami waves. The BTW map is able to communicate multiple pedestrian travel speeds, which are typically visualized by multiple maps with current LCD-based mapping practices. Results demonstrate that evacuation of Seaside is problematic seaward of the shore-parallel waterways for those with any limitations on mobility. Tsunami vertical-evacuation refuges or additional pedestrian bridges may be effective ways of reducing loss of life seaward of these waterways.

Initial management of hospital evacuations caused by Hurricane Rita: a systematic investigation.

PubMed

Downey, Erin L; Andress, Knox; Schultz, Carl H

2013-06-01

Hurricanes remain a major threat to hospitals throughout the world. The authors attempted to identify the planning areas that impact hospital management of evacuations and the challenges faced when sheltering-in-place. This observational, retrospective cohort study examined acute care institutions from one hospital system impacted by Hurricane Rita in 2005. Investigators used a standardized survey instrument and interview process, previously used in the hospital evacuation context, to examine hospitals' initial internal situational awareness and subsequent decision making that resulted in evacuation due to Hurricane Rita. Participants from each hospital included representatives from senior leadership and clinical and nonclinical staff that comprised the Incident Management Team (IMT). The main measured outcomes were responses to 95 questions contained in the survey. Seven of ten eligible hospitals participated in the study. All facilities evacuated the sickest patients first. The most significant factors prompting evacuation were the issuing of mandatory evacuation orders, storm dynamics (category, projected path, storm surge), and loss of regional communications. Hospitals that sheltered-in-place experienced staff shortages, interruptions to electrical power, and loss of water supplies. Three fully-evacuated institutions experienced understaffing of 40%-60%, and four hospitals sustained depressed staffing levels for over four weeks. Five hospitals lost electricity for a mean of 4.8 days (range .5-11 days). All facilities continued to receive patients to their Emergency Departments (EDs) while conducting their own evacuation. Hospital EDs should plan for continuous patient arrival during evacuation. Emergency Operation Plans (EOPs) that anticipate challenges associated with evacuation will help to maximize initial decision making and management during a crisis situation. Hospitals that shelter-in-place face critical shortages and must provide independent patient care for prolonged periods.

Post-nuclear disaster evacuation and survival amongst elderly people in Fukushima: A comparative analysis between evacuees and non-evacuees.

PubMed

Nomura, Shuhei; Blangiardo, Marta; Tsubokura, Masaharu; Nishikawa, Yoshitaka; Gilmour, Stuart; Kami, Masahiro; Hodgson, Susan

2016-01-01

Considering the health impacts of evacuation is fundamental to disaster planning especially for vulnerable elderly populations; however, evacuation-related mortality risks have not been well-investigated. We conducted an analysis to compare survival of evacuated and non-evacuated residents of elderly care facilities, following the Great East Japan Earthquake and subsequent Fukushima Dai-ichi nuclear power plant incident on 11th March 2011. To assess associations between evacuation and mortality after the Fukushima nuclear incident; and to present discussion points on disaster planning, with reference to vulnerable elderly populations. The study population comprised 1,215 residents admitted to seven elderly care facilities located 20-40km from the nuclear plant in the five years before the incident. Demographic and clinical characteristics were obtained from medical records. Evacuation histories were tracked until mid 2013. Main outcome measures are hazard ratios in evacuees versus non-evacuees using random-effects Cox proportional hazards models, and pre- and post-disaster survival probabilities and relative mortality incidence. Experiencing the disasters did not have a significant influence on mortality (hazard ratio 1.10, 95% confidence interval: 0.84-1.43). Evacuation was associated with 1.82 times higher mortality (95% confidence interval: 1.22-2.70) after adjusting for confounders, with the initial evacuation from the original facility associated with 3.37 times higher mortality risk (95% confidence interval: 1.66-6.81) than non evacuation. The government should consider updating its requirements for emergency planning for elderly facilities and ensure that, in a disaster setting, these facilities have the capacity and support to shelter in place for at least sufficient time to adequately prepare initial evacuation. Copyright © 2015 Elsevier Inc. All rights reserved.

Evacuating damaged and destroyed buildings on 9/11: behavioral and structural barriers.

PubMed

Groeger, Justina L; Stellman, Steven D; Kravitt, Alexandra; Brackbill, Robert M

2013-12-01

Evacuation of the World Trade Center (WTC) twin towers and surrounding buildings damaged in the September 11, 2001 attacks provides a unique opportunity to study factors that affect emergency evacuation of high rise buildings. Problem The goal of this study is to understand the extent to which structural and behavioral barriers and limitations of personal mobility affected evacuation by occupants of affected buildings on September 11, 2001. This analysis included 5,023 civilian, adult enrollees within the World Trade Center Health Registry who evacuated the two World Trade Center towers and over 30 other Lower Manhattan buildings that were damaged or destroyed on September 11, 2001. Multinomial logistic regression was used to predict total evacuation time (<30 to ≤60 minutes, >1 hour to <2 hours relative to ≤30 minutes) in relation to number of infrastructure barriers and number of behavioral barriers, adjusted for demographic and other factors. A higher percentage of evacuees reported encountering at least one behavioral barrier (84.9%) than reported at least one infrastructure barrier (51.9%). This pattern was consistent in all buildings except WTC 1, the first building attacked, where >90% of evacuees reported encountering both types of barriers. Smoke and poor lighting were the most frequently-reported structural barriers. Extreme crowding, lack of communication with officials, and being surrounded by panicked crowds were the most frequently-reported behavioral barriers. Multivariate analyses showed evacuation time to be independently associated with the number of each type of barrier as well as gender (longer times for women), but not with the floor from which evacuation began. After adjustment, personal mobility impairment was not associated with increased evacuation time. Because most high-rise buildings have unique designs, infrastructure factors tend to be less predictable than behavioral factors, but both need to be considered in developing emergency evacuation plans in order to decrease evacuation time and, consequently, risk of injury and death during an emergency evacuation.

Patient-driven resource planning of a health care facility evacuation.

PubMed

Petinaux, Bruno; Yadav, Kabir

2013-04-01

The evacuation of a health care facility is a complex undertaking, especially if done in an immediate fashion, ie, within minutes. Patient factors, such as continuous medical care needs, mobility, and comprehension, will affect the efficiency of the evacuation and translate into evacuation resource needs. Prior evacuation resource estimates are 30 years old. Utilizing a cross-sectional survey of charge nurses of the clinical units in an urban, academic, adult trauma health care facility (HCF), the evacuation needs of hospitalized patients were assessed periodically over a two-year period. Survey data were collected on 2,050 patients. Units with patients having low continuous medical care needs during an emergency evacuation were the postpartum, psychiatry, rehabilitation medicine, surgical, and preoperative anesthesia care units, the Emergency Department, and Labor and Delivery Department (with the exception of patients in Stage II labor). Units with patients having high continuous medical care needs during an evacuation included the neonatal and adult intensive care units, special procedures unit, and operating and post-anesthesia care units. With the exception of the neonate group, 908 (47%) of the patients would be able to walk out of the facility, 492 (25.5%) would require a wheelchair, and 530 (27.5%) would require a stretcher to exit the HCF. A total of 1,639 patients (84.9%) were deemed able to comprehend the need to evacuate and to follow directions; the remainder were sedated, blind, or deaf. The charge nurses also determined that 17 (6.9%) of the 248 adult intensive care unit patients were too ill to survive an evacuation, and that in 10 (16.4%) of the 61 ongoing surgery cases, stopping the case was not considered to be safe. Heath care facilities can utilize the results of this study to model their anticipated resource requirements for an emergency evacuation. This will permit the Incident Management Team to mobilize the necessary resources both within the facility and the community to provide for the safest evacuation of patients.

Assessing the vulnerability of the evacuation emergency plan: the case of the El Hierro, Canary Island, Spain

NASA Astrophysics Data System (ADS)

Marrero, J. M.; Garcia, A.; Llinares, A.; Lopez, P.; Ortinz, R.

2012-04-01

On July 17, 2011 an unrest was detected in the El Hierro island. A serretian submarine eruption started on October 10th in the southern area of the island, two miles away from La Restinga village. The analysis and interpretation of seismic and deformation data show a large volume of intruded magma. These data also show a high probability of a new vent opening. One of the most complex volcanic hazard scenarios is a new open vent in the El Golfo Valley, in the north slope of the island, where more than 5,000 people live. In this area there are only two possible terrestrial evacuation routes: 1) HI-1 road NE direction, the fastest but most vulnerable one, very near a 1,000 meters height cliff and through a 2 km tunnel with a structural deficiency that had to be closed during high energy periods of seismic activity; and 2) HI-1 road SW direction, a mountain road with many curves, frequent small landslides and fog. The Emergency Plan of the island takes into account the entire evacuation of El Golfo Valley in case of eruption. This process will be carried out by means of an assisted evacuation. The evacuees will be transported to a temporally regrouping shelter outside the valley to organize the transport to Tenerife Island. Only those people who have a second residence or relatives outside the affected area will be able to remain in the island. The evacuation time estimated by authorities for the entire evacuation of El Golfo Valley is of about 4 hours. This is extremely low considering: the complexity of the area; the number of evacuees; the lack of preparedness by the population; and adverse weather conditions. To evaluate the Evacuation Plan vulnerability, a series of evacuation scenarios have been simulated: self-evacuation; assisted evacuation; both terrestrial evacuation routes. The warning time, the response time by the population and the evacuation time have been taken into account.

Should We Stay Or Should We Go Now? Hazard Warnings, Risk Perception, and Evacuation Decisions at Pacaya Volcano, Guatemala During the 2010 Eruption.

NASA Astrophysics Data System (ADS)

Lechner, H. N.; Rouleau, M.

2017-12-01

Pacaya volcano, in Guatemala, presents considerable risk to nearby communities and in May 2010, the volcano experienced its largest eruption in more than a decade. The eruption damaged or destroyed hundreds of homes, injured scores of people with one fatality, and prompted the evacuation of approximately 2000 people from several communities. During this eruption crisis, people living within at-risk communities were presented with the choice to evacuate or remain in the hazard zone. Many chose not to leave. Using quantitative methodologies, this research investigates evacuation decisions through causal relationships between hazard warnings, evacuation orders, risk perception, evacuation intention and behavior, and attempts to understand why some people chose to stay in harm's-way. In October 2016, we conducted a door-to-door survey administered to 172 households in eight communities within 5 km of the active vent. Participants were asked to rank factors that influenced their decision to evacuate or not, their level of trust in emergency management agencies, and the intention to evacuate during a future crisis. Initial analysis suggests that many people have confidence in emergency management agencies and information from volcano scientists; however, during the 2010 eruption, warning messages and evacuation orders were based on previous eruption patterns and tephra distribution and therefore disseminated differentially to at-risk communities. This likely delayed evacuation decisions by households in the communities that were most affected by the eruption. The data also suggest that while many households perceive evacuation as the most effective protective action, the perceived risk to one's home and property may play a more important role in the decision making process. We will discuss these results as well as communication strategies between agencies and communities, and how to better facilitate more effective and successful evacuations during future eruption crises at Pacaya volcano.

Mental health status of World Trade Center tower survivors compared to other survivors a decade after the September 11, 2001 terrorist attacks.

PubMed

Gargano, Lisa M; Nguyen, Angela; DiGrande, Laura; Brackbill, Robert M

2016-09-01

Studies of individuals directly exposed to the World Trade Center (WTC) terrorist attacks of September 11, 2001 have found increased risk for post-traumatic stress disorder (PTSD) and binge drinking (BD). No long-term studies have been conducted on one highly exposed group, WTC tower evacuees. The study sample included 7,695 adult civilians in the WTC Health Registry. Logistic regression was used to examine the odds of PTSD and BD in 1,946 towers evacuees compared to 5,749 others in nearby buildings or on the street. WTC tower survivors were at increased risk for PTSD and BD compared to the others. Infrastructure and behavioral barriers experienced during evacuation were significantly associated with PTSD. WTC tower evacuees are at increased risk for PTSD and BD. Understanding the effects of disaster-related evacuation barriers on the long-term mental health status of survivors can help in the planning of continuing post-disaster treatment. Am. J. Ind. Med. 59:742-751, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A safe treatment option for esophageal bezoars

PubMed Central

Yaqub, Sheraz; Shafique, Muhammad; Kjæstad, Erik; Thorsen, Yngve; Lie, Erik S.; Dahl, Vegard; Bakka, Njål; Røkke, Ola

2012-01-01

INTRODUCTION Bezoar in the esophagus is a rare condition and associated with structural or functional abnormalities of the esophagus. Endoscopy is the main tool for diagnosis and treatment for bezoar in the esophagus. PRESENTATION OF CASE Here we present a case where an endoscopic evacuation of an esophageal bezoar was unsuccessful. We treated the bezoar through a nasogastric tube using a cocktail composed of pancreatic enzymes dissolved in Coca-Cola. DISCUSSION Endoscopy is regarded as the mainstay for the diagnosis and treatment of esophageal bezoars. However, when this approach fails, other treatment options include dissolution therapy, and surgical exploration and removal of the bezoar. Surgical removal of an esophageal bezoar is associated with a high risk of morbidity and mortality. We advocate that dissolving therapy should be the first choice of treatment when endoscopic evacuation is not possible. CONCLUSION This is the first report describing a successful treatment of an esophageal bezoar with a cocktail of Coca-Cola and pancreatic enzymes. It is an effective, inexpensive, and worldwide available treatment and should be considered when endoscopic evacuation fails. PMID:22609703

[Aeromedical evacuation of critically ill patients in developing countries A retrospective study on 244 patients in Djibouti].

PubMed

Bordes, J; Loheas, D; Benois, A

2015-01-01

The pratice of intensive care in Africa is marked by a wide variety of health care delivery. Only a few centers offer specialized intensive care units, as cardiac or neurological units. That may explain the need for aeromedical evacuations for patients whose condition exceeds local capacity. Our objective was to assess whether the proportion of patients admitted to intensive care and evacuated had increased between 1997 and 2013 in a developing country, Djibouti. We examined the activity register of Bouffard Hospital intensive care unit in Djibouti to determine the number and characteristics of patients evacuated by air ambulance during a 16 years period. From January 1997 to December 2013, a total of 244 patients were evacuated. The evacuation rate was 5.74ù of the patients admitted to the entire duration of the study. The rate of patients evacuated was not different between 1997 and 2013 (5,69ù versus 8,33ù respectively, p = 0,269). However, the rate of djiboutian evacuated patients was statistically different between 1997 and 2013 (0,96ù versus 4,46ù, p = 0,02). The main causes were severe trauma injuries, cardiovascular diseases and neurological diseases. The aeromedical evacuation of a critically ill patient in a developing country is a process requiring heavy logistics and depending on the medical skills available in the area, and financial resources that can be implemented for the patient. Our study shows that medical evacuations in favor of Djiboutian patients are marginal but are increasing over the past decade.

Evacuation dynamic and exit optimization of a supermarket based on particle swarm optimization

NASA Astrophysics Data System (ADS)

Li, Lin; Yu, Zhonghai; Chen, Yang

2014-12-01

A modified particle swarm optimization algorithm is proposed in this paper to investigate the dynamic of pedestrian evacuation from a fire in a public building-a supermarket with multiple exits and configurations of counters. Two distinctive evacuation behaviours featured by the shortest-path strategy and the following-up strategy are simulated in the model, accounting for different categories of age and sex of the pedestrians along with the impact of the fire, including gases, heat and smoke. To examine the relationship among the progress of the overall evacuation and the layout and configuration of the site, a series of simulations are conducted in various settings: without a fire and with a fire at different locations. Those experiments reveal a general pattern of two-phase evacuation, i.e., a steep section and a flat section, in addition to the impact of the presence of multiple exits on the evacuation along with the geographic locations of the exits. For the study site, our simulations indicated the deficiency of the configuration and the current layout of this site in the process of evacuation and verified the availability of proposed solutions to resolve the deficiency. More specifically, for improvement of the effectiveness of the evacuation from the site, adding an exit between Exit 6 and Exit 7 and expanding the corridor at the right side of Exit 7 would significantly reduce the evacuation time.

Modeling Evacuation of a Hospital without Electric Power.

PubMed

Vugrin, Eric D; Verzi, Stephen J; Finley, Patrick D; Turnquist, Mark A; Griffin, Anne R; Ricci, Karen A; Wyte-Lake, Tamar

2015-06-01

Hospital evacuations that occur during, or as a result of, infrastructure outages are complicated and demanding. Loss of infrastructure services can initiate a chain of events with corresponding management challenges. This report describes a modeling case study of the 2001 evacuation of the Memorial Hermann Hospital in Houston, Texas (USA). The study uses a model designed to track such cascading events following loss of infrastructure services and to identify the staff, resources, and operational adaptations required to sustain patient care and/or conduct an evacuation. The model is based on the assumption that a hospital's primary mission is to provide necessary medical care to all of its patients, even when critical infrastructure services to the hospital and surrounding areas are disrupted. Model logic evaluates the hospital's ability to provide an adequate level of care for all of its patients throughout a period of disruption. If hospital resources are insufficient to provide such care, the model recommends an evacuation. Model features also provide information to support evacuation and resource allocation decisions for optimizing care over the entire population of patients. This report documents the application of the model to a scenario designed to resemble the 2001 evacuation of the Memorial Hermann Hospital, demonstrating the model's ability to recreate the timeline of an actual evacuation. The model is also applied to scenarios demonstrating how its output can inform evacuation planning activities and timing.

Does Non-Compliance with Route/Destination Assignment Compromise Evacuation Efficiency?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yuan, Fang; Han, Lee; Chin, Shih-Miao

2007-01-01

This paper documents studies of two real-world network evacuation cases, each with a different, but proven, simulation software package. The purpose of these studies was to examine whether the rate of evacuees' compliance with predetermined route/destination assignments would have an impact on the efficiency of evacuation operations. Results from both cases suggest that a rate of less than 100% compliance does not compromise evacuation efficiency. In fact, although this is counter-intuitive, evacuation efficiency would actually improve as a result of "sensible" non-compliance on the part of the evacuees. A closer observation of the results revealed that the somewhat unexpected improvementmore » results from a reduction in congestion along designated evacuation routes as evacuees spread out to less prominent parallel streets and other non-congested outbound routes. This suggests that by being limited by the zone-to-zone and one-to-one assignment framework, conventional evacuation plans may have fallen short of providing the most efficient guidance to evacuees. To address this issue, some systematic means, perhaps simulation-based, should be performed to assess the zone partitions, route designations, and destination assignments in existing evacuation plans. Thus, evacuation planning with route/destination assignments based on origin zones may be flawed and may deserve reconsideration. After all, once en route, where an evacuee is coming from is of far less consequence than where he or she is going.« less

[Ultrasound scattering properties of Albunex microspheres].

PubMed

Takamoto, T; Shiina, T

1998-04-01

In Japan, clinical and basic investigations of Albunex were started from 1989, and was firstly approved by the government as a commercially available contrast agent for the cardiovascular disorders. Although it has recently evacuated from the market, its acoustic properties proven by the many investigators were valuable for preparation of the second generation of contrast agents. Therefore, we summarized our data of the ultrasonic properties of Albunex both in vitro and experimental dog studies using RF signals. In conclusion, Albunex was a extremely sensitive blood flow tracer in evaluating intracardiac blood flow as well as intramyocardial perfusion.

The application of Firefly algorithm in an Adaptive Emergency Evacuation Centre Management (AEECM) for dynamic relocation of flood victims

NASA Astrophysics Data System (ADS)

ChePa, Noraziah; Hashim, Nor Laily; Yusof, Yuhanis; Hussain, Azham

2016-08-01

Flood evacuation centre is defined as a temporary location or area of people from disaster particularly flood as a rescue or precautionary measure. Gazetted evacuation centres are normally located at secure places which have small chances from being drowned by flood. However, due to extreme flood several evacuation centres in Kelantan were unexpectedly drowned. Currently, there is no study done on proposing a decision support aid to reallocate victims and resources of the evacuation centre when the situation getting worsens. Therefore, this study proposes a decision aid model to be utilized in realizing an adaptive emergency evacuation centre management system. This study undergoes two main phases; development of algorithm and models, and development of a web-based and mobile app. The proposed model operates using Firefly multi-objective optimization algorithm that creates an optimal schedule for the relocation of victims and resources for an evacuation centre. The proposed decision aid model and the adaptive system can be applied in supporting the National Security Council's respond mechanisms for handling disaster management level II (State level) especially in providing better management of the flood evacuating centres.

Enhancing Evacuation Plans with a Situation Awareness System Based on End-User Knowledge Provision

PubMed Central

Morales, Augusto; Alcarria, Ramon; Martin, Diego; Robles, Tomas

2014-01-01

Recent disasters have shown that having clearly defined preventive procedures and decisions is a critical component that minimizes evacuation hazards and ensures a rapid and successful evolution of evacuation plans. In this context, we present our Situation-Aware System for enhancing Evacuation Plans (SASEP) system, which allows creating end-user business rules that technically support the specific events, conditions and actions related to evacuation plans. An experimental validation was carried out where 32 people faced a simulated emergency situation, 16 of them using SASEP and the other 16 using a legacy system based on static signs. From the results obtained, we compare both techniques and discuss in which situations SASEP offers a better evacuation route option, confirming that it is highly valuable when there is a threat in the evacuation route. In addition, a study about user satisfaction using both systems is presented showing in which cases the systems are assessed as satisfactory, relevant and not frustrating. PMID:24961212

Enhancing evacuation plans with a situation awareness system based on end-user knowledge provision.

PubMed

Morales, Augusto; Alcarria, Ramon; Martin, Diego; Robles, Tomas

2014-06-24

Recent disasters have shown that having clearly defined preventive procedures and decisions is a critical component that minimizes evacuation hazards and ensures a rapid and successful evolution of evacuation plans. In this context, we present our Situation-Aware System for enhancing Evacuation Plans (SASEP) system, which allows creating end-user business rules that technically support the specific events, conditions and actions related to evacuation plans. An experimental validation was carried out where 32 people faced a simulated emergency situation, 16 of them using SASEP and the other 16 using a legacy system based on static signs. From the results obtained, we compare both techniques and discuss in which situations SASEP offers a better evacuation route option, confirming that it is highly valuable when there is a threat in the evacuation route. In addition, a study about user satisfaction using both systems is presented showing in which cases the systems are assessed as satisfactory, relevant and not frustrating.

Elementary students' evacuation route choice in a classroom: A questionnaire-based method

NASA Astrophysics Data System (ADS)

Chen, Liang; Tang, Tie-Qiao; Huang, Hai-Jun; Song, Ziqi

2018-02-01

Children evacuation is a critical but challenging issue. Unfortunately, existing researches fail to effectively describe children evacuation, which is likely due to the lack of experimental and empirical data. In this paper, a questionnaire-based experiment was conducted with children aged 8-12 years to study children route choice behavior during evacuation from in a classroom with two exits. 173 effective questionnaires were collected and the corresponding data were analyzed. From the statistical results, we obtained the following findings: (1) position, congestion, group behavior, and backtracking behavior have significant effects on children route choice during evacuation; (2) age only affects children backtracking behavior, and (3) no prominent effects based on gender and guidance were observed. The above findings may help engineers design some effective evacuation strategies for children.

Necessity of guides in pedestrian emergency evacuation

NASA Astrophysics Data System (ADS)

Yang, Xiaoxia; Dong, Hairong; Yao, Xiuming; Sun, Xubin; Wang, Qianling; Zhou, Min

2016-01-01

The role of guide who is in charge of leading pedestrians to evacuate in the case of emergency plays a critical role for the uninformed people. This paper first investigates the influence of mass behavior on evacuation dynamics and mainly focuses on the guided evacuation dynamics. In the extended crowd model proposed in this paper, individualistic behavior, herding behavior and environment influence are all considered for pedestrians who are not informed by the guide. According to the simulation results, herding behavior makes more pedestrians evacuate from the room in the same period of time. Besides, guided crowd demonstrates the same behavior of group dynamics which is characterized by gathering, conflicts and balance. Moreover, simulation results indicate guides with appropriate initial positions and quantity are more conducive to evacuation under a moderate initial density of pedestrians.

Tsunami vertical-evacuation planning in the U.S. Pacific Northwest as a geospatial, multi-criteria decision problem

USGS Publications Warehouse

Wood, Nathan; Jones, Jeanne; Schelling, John; Schmidtlein, Mathew

2014-01-01

Tsunami vertical-evacuation (TVE) refuges can be effective risk-reduction options for coastal communities with local tsunami threats but no accessible high ground for evacuations. Deciding where to locate TVE refuges is a complex risk-management question, given the potential for conflicting stakeholder priorities and multiple, suitable sites. We use the coastal community of Ocean Shores (Washington, USA) and the local tsunami threat posed by Cascadia subduction zone earthquakes as a case study to explore the use of geospatial, multi-criteria decision analysis for framing the locational problem of TVE siting. We demonstrate a mixed-methods approach that uses potential TVE sites identified at community workshops, geospatial analysis to model changes in pedestrian evacuation times for TVE options, and statistical analysis to develop metrics for comparing population tradeoffs and to examine influences in decision making. Results demonstrate that no one TVE site can save all at-risk individuals in the community and each site provides varying benefits to residents, employees, customers at local stores, tourists at public venues, children at schools, and other vulnerable populations. The benefit of some proposed sites varies depending on whether or not nearby bridges will be functioning after the preceding earthquake. Relative rankings of the TVE sites are fairly stable under various criteria-weighting scenarios but do vary considerably when comparing strategies to exclusively protect tourists or residents. The proposed geospatial framework can serve as an analytical foundation for future TVE siting discussions.

Surgical Evacuation of Spontaneous Supratentorial Lobar Intracerebral Hemorrhage: Comparison of Safety and Efficacy of Stereotactic Aspiration, Endoscopic Surgery, and Craniotomy.

PubMed

Li, Yuqian; Yang, Ruixin; Li, Zhihong; Yang, Yanping; Tian, Bo; Zhang, Xingye; Wang, Bao; Lu, Dan; Guo, Shaochun; Man, Minghao; Yang, Yang; Luo, Tao; Gao, Guodong; Li, Lihong

2017-09-01

The safety and efficacy of craniotomy, endoscopic surgery, and stereotactic aspiration for surgical evacuation of spontaneous supratentorial lobar intracerebral hemorrhage (ICH) is yet uncertain. The present study analyzed the clinical and radiographic data from 99 patients with spontaneous supratentorial lobar ICH, retrospectively, to address this issue. Patients who underwent craniotomy, endoscopy surgery, or stereotactic aspiration were assigned to the craniotomy group (n = 31), endoscopy surgery group (n = 32), or stereotactic aspiration group (n = 36), respectively. The characteristics of all the enrolled patients at the time of admission were assimilated. Also, the therapeutic effects of the three surgical procedures were evaluated based on short-term outcomes within 30 days and long-term outcomes at 6 months after the ictus. The results showed that stereotactic aspiration and endoscopic surgery were associated with a superior clinical therapeutic effect in both short-term and long-term outcomes than craniotomy for the treatment of spontaneous supratentorial lobar ICH. Notably, severely affected patients with hematoma volume > 60 mL or Glasgow Coma Scale score 4-8 may benefit more from endoscopic surgery than the two other surgical procedures. The current findings demonstrate that both stereotactic aspiration and endoscopic surgery possess an apparent advantage over craniotomy for the evacuation of spontaneous supratentorial lobar ICH. The endoscopic surgery might be more safe and effective with higher evacuation rate, better functional neurological outcomes, and lower complication and mortality rates. Copyright © 2017 Elsevier Inc. All rights reserved.

Lessons learned from the 2010 evacuations at Merapi volcano

NASA Astrophysics Data System (ADS)

Mei, Estuning Tyas Wulan; Lavigne, Franck; Picquout, Adrien; de Bélizal, Edouard; Brunstein, Daniel; Grancher, Delphine; Sartohadi, Junun; Cholik, Noer; Vidal, Céline

2013-07-01

The rapid onset and large magnitude of the 2010 eruption of Merapi posed significant challenges for evacuations and resulted in a peak number of almost 400,000 Internally Displaced Persons (IDPs). A pre-existing hazard map and an evacuation plan based on the relatively small magnitude of previous eruptions of the 20th century were utilized by emergency officials during the initial phase of the eruption (25 October-3 November, 2010). However, when the magnitude of the eruption increased greatly on 3-5 November 2010, the initial evacuation plan had to be abandoned as danger zones were expanded rapidly and the scale and pace of the evacuation increased dramatically. Fortunately, orders to evacuate were communicated quickly through a variety of communication methods and as a result many thousands of lives were saved. However, there were also problems that resulted from this rapid and larger-than-expected evacuation; and there were lessons learned that can improve future mass evacuations at Merapi and other volcanoes. We analyzed the results of 1969 questionnaires and conducted a series of interviews with community leaders and emergency officials. Results were compiled for periods both during and after the 2010 eruption. Our results show that: (1) trust in the Indonesian government and volcanologists was very high after the eruption; (2) multiple modes of communication were used to relay warnings and evacuation orders; (3) 50% to 70% of IDPs returned to the danger zone during the crisis despite evacuation orders; (4) preparation before the eruption was critical to the successes and included improvements to roads and education programs, (5) public education about hazards and evacuation protocols before the eruption was focused in the perceived highest danger zone where it was effective yet, confusion and loss of life in other areas demonstrated that education programs in all hazard zones are needed to prepare for larger-than-normal eruptions, and (6) improvements in registration of evacuees, in providing for livestock, and in activities and work programs in evacuation camps (as well as government restrictions and policy changes) are also needed to prevent evacuees from returning to their homes during the crisis period.

Aero-medical evacuation from the second Israel-Lebanon war: a descriptive study.

PubMed

Schwartz, Dagan; Resheff, Avram; Geftler, Alex; Weiss, Aviram; Birenbaum, Erez; Lavon, Ophir

2009-05-01

The second Lebanon war started as a limited operation and progressed to a large-scale campaign. Most of the fighting took place in mountainous villages and small towns inhabited with civilians. The Israeli Defense Forces (IDF) Airborne rescue and evacuation unit is charged with air evacuation of soldiers and civilians in times of peace, limited conflict, and war. We describe this unit's activities in the second Lebanon war, analyzing injury, treatment, and evacuation characteristics Data were collected from flight medical reports, debriefings of aero-medical team members (usually immediately upon return from mission), ground units medical reports and debriefings, and hospital records. 725 IDF soldiers were injured and 117 killed either in Lebanon or near the Israeli-Lebanese border during the war. A total of 338 (46%) were evacuated in 95 airlifts (averaging 4.5 evacuees per airlift) from the fighting zones or the border. Air evacuation used dedicated helicopters with advanced care capacities, and most victims were evacuated straight from the battlefield, as the fighting was ensuing. Many wounded first received advanced medical care upon the arrival of the aero-medical teams. In military operations within civilian populated areas with threats to ground transport, air evacuation can sometimes be the only readily available option. Providing timely ground advanced medical care proved difficult in many instances. Thus, for many, the rescue helicopter was the first point of access to such care. Aero-medical aircrafts and personnel faced threats from gunfire and missiles, causing both delays in evacuation and a high average number of evacuees per airlift. This article proposes ways of coping with situations in which similar rescue and evacuation problems are likely.

Evacuation decisions in a chemical air pollution incident: cross sectional survey

PubMed Central

Kinra, S; Lewendon, G; Nelder, R; Herriott, N; Mohan, R; Hort, M; Harrison, S; Murray, V

2005-01-01

Objective To compare the health outcomes in sheltered and evacuated populations after a chemical incident in a plastics factory. Design Cross sectional survey. Setting Urban area in southwest England. Participants 1750 residents from the area exposed to the chemical smoke, of which 472 were evacuated and the remaining 1278 were advised to shelter indoors. Main outcome measure Number of adverse health symptoms. A case was defined by the presence of four or more symptoms. Main results 1096 residents (63%; 299 evacuated, 797 sheltered) provided data for analyses. The mean symptom score and proportion of cases were higher in evacuated people than in the sheltered population (evacuated: symptom score 1.9, cases 19.7% (n = 59); sheltered: symptom score 1.0, cases 9.5% (n = 76); P < 0.001 for both). The difference between the two groups attenuated markedly at the end of two weeks from the start of the incident. The two main modifiable risk factors for the odds of becoming a case were evacuation (odds ratio 2.5, 95% confidence interval 1.7 to 3.8) and direct exposure to smoke for more than two hours on the first day of the incident (2.0, 1.7 to 2.3). The distance of residence from the factory or level of exposure before intervention (first six hours) had little effect on the odds of a person becoming a case. Conclusions Sheltering may have been a better protective action than evacuation in this chemical incident, which is consistent with the prevailing expert view. Although this study has limitations, it is based on a real event. Evacuations carry their own risks and resource implications; increased awareness may help to reduce unnecessary evacuations in the future. PMID:15976419

Enhancing resource coordination for multi-modal evacuation planning.

DOT National Transportation Integrated Search

2013-01-01

This research project seeks to increase knowledge about coordinating effective multi-modal evacuation for disasters. It does so by identifying, evaluating, and assessing : current transportation management approaches for multi-modal evacuation planni...

Guidelines for hurricane evacuation signing and markings

DOT National Transportation Integrated Search

2007-12-01

Based on focus group input and surveys of motorists who have recent hurricane evacuation experience, researchers developed guidelines for various hurricane evacuation signs and markings, including route signs, contraflow signs, emergency shoulder lan...

Pedestrian flow-path modeling to support tsunami-evacuation planning

NASA Astrophysics Data System (ADS)

Wood, N. J.; Jones, J. M.; Schmidtlein, M.

2015-12-01

Near-field tsunami hazards are credible threats to many coastal communities throughout the world. Along the U.S. Pacific Northwest coast, low-lying areas could be inundated by a series of catastrophic tsunamis potentially arriving in a matter of minutes following a Cascadia subduction zone (CSZ) earthquake. We developed a geospatial-modeling method for characterizing pedestrian-evacuation flow paths and evacuation basins to support evacuation and relief planning efforts for coastal communities in this region. We demonstrate this approach using the coastal communities of Aberdeen, Hoquiam, and Cosmopolis in southwestern Grays Harbor County, Washington (USA), where previous research suggests approximately 20,500 people (99% of the residents in tsunami-hazard zones) will likely have enough time to evacuate before tsunami-wave arrival. Geospatial, anisotropic, path distance models were developed to map the most efficient pedestrian paths to higher ground from locations within the tsunami-hazard zone. This information was then used to identify evacuation basins, outlining neighborhoods sharing a common evacuation pathway to safety. We then estimated the number of people traveling along designated evacuation pathways and arriving at pre-determined safe assembly areas, helping determine shelter demand and relief support (e.g., for elderly individuals or tourists). Finally, we assessed which paths may become inaccessible due to earthquake-induced ground failures, a factor which may impact an individual's success in reaching safe ground. The presentation will include a discussion of the implications of our analysis for developing more comprehensive coastal community tsunami-evacuation planning strategies worldwide.

Study of the oxidation of uranium by external and diffuse reflectance FTIR spectroscopy using remote-sensing and evacuable cell techniques

NASA Astrophysics Data System (ADS)

Powell, G. L.; Dobbins, A.; Cristy, S. S.; Cliff, T. L.; Meyer, H. M., III; Lucania, J.; Milosevic, Milan

1994-01-01

This report describes the application of reflectance FTIR spectroscopy to the measurement of the oxidation rate of uranium by environmental gases near room temperature. It also describes very efficient evacuable cells designed for 75 degree(s) external reflectance with polarized light and for diffuse reflectance using mid-infrared FTIR spectroscopy. These cells, along with functionally similar remote sensing accessories, have been applied to the study of the oxidation of uranium metal in air, oxygen, and water vapor by precisely measuring the 575 cm-1 band of UO2 and other properties of the corrosion film such as absorbed water and reflective losses caused by film degradation related to pitting or nucleation phenomena.

Disentangling the Impact of Social Groups on Response Times and Movement Dynamics in Evacuations

PubMed Central

Bode, Nikolai W. F.; Holl, Stefan; Mehner, Wolfgang; Seyfried, Armin

2015-01-01

Crowd evacuations are paradigmatic examples for collective behaviour, as interactions between individuals lead to the overall movement dynamics. Approaches assuming that all individuals interact in the same way have significantly improved our understanding of pedestrian crowd evacuations. However, this scenario is unlikely, as many pedestrians move in social groups that are based on friendship or kinship. We test how the presence of social groups affects the egress time of individuals and crowds in a representative crowd evacuation experiment. Our results suggest that the presence of social groups increases egress times and that this is largely due to differences at two stages of evacuations. First, individuals in social groups take longer to show a movement response at the start of evacuations, and, second, they take longer to move into the vicinity of the exits once they have started to move towards them. Surprisingly, there are no discernible time differences between the movement of independent individuals and individuals in groups directly in front of the exits. We explain these results and discuss their implications. Our findings elucidate behavioural differences between independent individuals and social groups in evacuations. Such insights are crucial for the control of crowd evacuations and for planning mass events. PMID:25785603

A microcomputer based traffic evacuation modeling system for emergency planning application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rathi, A.K.

1995-12-31

The US Army stockpiles unitary chemical weapons, both as bulk chemicals and as munitions, at eight major sites in the United States. The continued storage and disposal of the chemical stockpile has the potential for accidental releases of toxic gases that could escape the installation boundaries and pose a threat to the civilian population in the vicinity. Vehicular evacuation is one of the major and often preferred protective action options available for emergency management in a real or anticipated disaster. Computer simulation models of evacuation traffic flow are used to estimate the time required for the affected populations to evacuatemore » to safer areas, to evaluate effectiveness of vehicular evacuations as a protective action option, and to develop comprehensive evacuation plans when required. Following a review of the past efforts to simulate traffic flow during emergency evacuations, an overview of the key features in Version 2.0 of the Oak Ridge Evacuation Modeling System (OREMS) are presented in this paper. OREMS is a microcomputer-based model developed to simulate traffic flow during regional emergency evacuations. OREMS integrates a state-of-the-art dynamic traffic flow and simulation model with advanced data editing and output display programs operating under a MS-Windows environment.« less

The effect of overwing hatch placement on evacuation from smaller transport aircraft.

PubMed

Wilson, Rebecca L; Muir, Helen C

2010-02-01

Overwing exits are installed on a number of smaller transport aircraft. With a traditional overwing exit, once released, the hatch is not attached to the fuselage and will fall into the cabin. To operate, the hatch has to be brought inwards, manoeuvred and placed in a location where it does not obstruct egress. Accidents and experimental studies have shown that the hatch is not always disposed of into an appropriate location. Evacuation trials from a smaller transport aircraft cabin were conducted. The placement of the exit hatch was manipulated. The results indicated that hatch placement had a significant effect on passenger evacuation rates from a smaller transport aircraft, with the internal placement tested resulting in slower evacuation rates. The study has highlighted the importance of operators disposing of the hatch into a location whereby it does not impede egress. One way to ensure this would be the installation of an automatically disposed hatch. Statement of Relevance: It is important that all occupants can evacuate an aircraft rapidly if required. The influence of overwing hatch placement on evacuation from smaller transport aircraft was addressed Evacuation trials concluded that an inappropriately placed hatch can negatively influence evacuation rates. Improvements to exit design and passenger education were suggested.

Condition for dust evacuation from the first galaxies

NASA Astrophysics Data System (ADS)

Fukushima, Hajime; Yajima, Hidenobu; Omukai, Kazuyuki

2018-06-01

Dust enables low-mass stars to form from low-metallicity gas by inducing fragmentation of clouds via cooling by thermal emission. Dust may, however, be evacuated from star-forming clouds due to the radiation force from massive stars. We study here the condition for dust evacuation by comparing the dust evacuation time with the time of cloud destruction due to either expansion of H II regions or supernovae. The cloud destruction time has a weak dependence on cloud radius, while the dust evacuation time is shorter for a cloud with a smaller radius. Dust evacuation, thus, occurs in compact star-forming clouds whose column density is NH ≃ 1024-1026 cm-2. The critical halo mass above which dust evacuation occurs is lower for higher formation red shift, e.g. ˜109 M⊙ at red shift z ˜ 3 and ˜107 M⊙ at z ˜ 9. In addition, the metallicity of the gas should be less than ˜10-2 Z⊙, otherwise attenuation by dust reduces the radiation force significantly. From the dust-evacuated gas, massive stars are likely to form, even with a metallicity above ˜10-5 Z⊙, the critical value for low-mass star formation due to dust cooling. This can explain the dearth of ultra-metal-poor stars with a metallicity lower than ˜10-4 Z⊙.

Risk of large-scale evacuation based on the effectiveness of rescue strategies under different crowd densities.

PubMed

Wang, Jinghong; Lo, Siuming; Wang, Qingsong; Sun, Jinhua; Mu, Honglin

2013-08-01

Crowd density is a key factor that influences the moving characteristics of a large group of people during a large-scale evacuation. In this article, the macro features of crowd flow and subsequent rescue strategies were considered, and a series of characteristic crowd densities that affect large-scale people movement, as well as the maximum bearing density when the crowd is extremely congested, were analyzed. On the basis of characteristic crowd densities, the queuing theory was applied to simulate crowd movement. Accordingly, the moving characteristics of the crowd and the effects of typical crowd density-which is viewed as the representation of the crowd's arrival intensity in front of the evacuation passageways-on rescue strategies was studied. Furthermore, a "risk axle of crowd density" is proposed to determine the efficiency of rescue strategies in a large-scale evacuation, i.e., whether the rescue strategies are able to effectively maintain or improve evacuation efficiency. Finally, through some rational hypotheses for the value of evacuation risk, a three-dimensional distribution of the evacuation risk is established to illustrate the risk axle of crowd density. This work aims to make some macro, but original, analysis on the risk of large-scale crowd evacuation from the perspective of the efficiency of rescue strategies. © 2012 Society for Risk Analysis.

A Global System for Transportation Simulation and Visualization in Emergency Evacuation Scenarios

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lu, Wei; Liu, Cheng; Thomas, Neil

2015-01-01

Simulation-based studies are frequently used for evacuation planning and decision making processes. Given the transportation systems complexity and data availability, most evacuation simulation models focus on certain geographic areas. With routine improvement of OpenStreetMap road networks and LandScanTM global population distribution data, we present WWEE, a uniform system for world-wide emergency evacuation simulations. WWEE uses unified data structure for simulation inputs. It also integrates a super-node trip distribution model as the default simulation parameter to improve the system computational performance. Two levels of visualization tools are implemented for evacuation performance analysis, including link-based macroscopic visualization and vehicle-based microscopic visualization. Formore » left-hand and right-hand traffic patterns in different countries, the authors propose a mirror technique to experiment with both scenarios without significantly changing traffic simulation models. Ten cities in US, Europe, Middle East, and Asia are modeled for demonstration. With default traffic simulation models for fast and easy-to-use evacuation estimation and visualization, WWEE also retains the capability of interactive operation for users to adopt customized traffic simulation models. For the first time, WWEE provides a unified platform for global evacuation researchers to estimate and visualize their strategies performance of transportation systems under evacuation scenarios.« less

Fleeing The Storm(s): An Examination of Evacuation Behavior During Florida’s 2004 Hurricane Season

PubMed Central

SMITH, STANLEY K.; MCCARTY, CHRIS

2009-01-01

The 2004 hurricane season was the worst in Florida’s history, with four hurricanes causing at least 47 deaths and some $45 billion in damages. To collect information on the demographic impact of those hurricanes, we surveyed households throughout the state and in the local areas that sustained the greatest damage. We estimate that one-quarter of Florida’s population evacuated prior to at least one hurricane; in some areas, well over one-half of the residents evacuated at least once, and many evacuated several times. Most evacuees stayed with family or friends and were away from home for only a few days. Using logistic regression analysis, we found that the strength of the hurricane and the vulnerability of the housing unit had the greatest impact on evacuation behavior; additionally, several demographic variables had significant effects on the probability of evacuating and the choice of evacuation lodging (family/friends, public shelters, or hotels/motels). With continued population growth in coastal areas and the apparent increase in hurricane activity caused by global warming, threats posed by hurricanes are rising in the United States and throughout the world. We believe the present study will help government officials plan more effectively for future hurricane evacuations. PMID:19348112

Evacuee Compliance Behavior Analysis using High Resolution Demographic Information

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lu, Wei; Han, Lee; Liu, Cheng

2014-01-01

The purpose of this study is to examine whether evacuee compliance behavior with route assignments from different resolutions of demographic data would impact the evacuation performance. Most existing evacuation strategies assume that travelers will follow evacuation instructions, while in reality a certain percent of evacuees do not comply with prescribed instructions. In this paper, a comparison study of evacuation assignment based on Traffic Analysis Zones (TAZ) and high resolution LandScan USA Population Cells (LPC) were conducted for the detailed road network representing Alexandria, Virginia. A revised platform for evacuation modeling built on high resolution demographic data and activity-based microscopic trafficmore » simulation is proposed. The results indicate that evacuee compliance behavior affects evacuation efficiency with traditional TAZ assignment, but it does not significantly compromise the efficiency with high resolution LPC assignment. The TAZ assignment also underestimates the real travel time during evacuation, especially for high compliance simulations. This suggests that conventional evacuation studies based on TAZ assignment might not be effective at providing efficient guidance to evacuees. From the high resolution data perspective, traveler compliance behavior is an important factor but it does not impact the system performance significantly. The highlight of evacuee compliance behavior analysis should be emphasized on individual evacuee level route/shelter assignments, rather than the whole system performance.« less

Lightweight cryogenic-compatible pressure vessels for vehicular fuel storage

DOEpatents

Aceves, Salvador; Berry, Gene; Weisberg, Andrew H.

2004-03-23

A lightweight, cryogenic-compatible pressure vessel for flexibly storing cryogenic liquid fuels or compressed gas fuels at cryogenic or ambient temperatures. The pressure vessel has an inner pressure container enclosing a fuel storage volume, an outer container surrounding the inner pressure container to form an evacuated space therebetween, and a thermal insulator surrounding the inner pressure container in the evacuated space to inhibit heat transfer. Additionally, vacuum loss from fuel permeation is substantially inhibited in the evacuated space by, for example, lining the container liner with a layer of fuel-impermeable material, capturing the permeated fuel in the evacuated space, or purging the permeated fuel from the evacuated space.

Evacuating populations with special needs

DOT National Transportation Integrated Search

2009-04-01

Evacuation operations are conducted under the authority of, and based on decisions by, local and state authorities. The purpose of this primer, Evacuating Populations with Special Needs, is to provide local and state emergency managers, government of...

Psychiatric Outpatients After the 3.11 Complex Disaster in Fukushima, Japan.

PubMed

Hori, Arinobu; Hoshino, Hiroshi; Miura, Itaru; Hisamura, Masaki; Wada, Akira; Itagaki, Shuntaro; Kunii, Yasuto; Matsumoto, Junya; Mashiko, Hirobumi; Katz, Craig L; Yabe, Hirooki; Niwa, Shin-Ichi

After the 3.11 complex disaster, fear of radioactive contamination and forced evacuation influenced a number of residents to seek psychiatric care. This study assessed the sequential changes in the number of new outpatients and patients with acute stress disorder (ASD), post-traumatic stress disorder (PTSD), adjustment disorder, and depression after the Fukushima disaster. We distributed questionnaires to 77 psychiatric institutions to determine the number of new outpatients between March and June in 2010, 2011, and 2012. There were 771, 1000, and 733 new patients in 2010, 2011, and 2012, respectively. We observed a statistically significant increase in new patients with ASD or PTSD and a significant decrease in patients with depression in 2011, which returned to predisaster levels in 2012. There were time- and disease-dependent changes in the numbers of psychiatric care-seeking individuals after the 3.11 complex disaster in Fukushima. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Participatory action research methodology in disaster research: results from the World Trade Center evacuation study.

PubMed

Gershon, Robyn R M; Rubin, Marcie S; Qureshi, Kristine A; Canton, Allison N; Matzner, Frederick J

2008-10-01

Participatory action research (PAR) methodology is an effective tool in identifying and implementing risk-reduction interventions. It has been used extensively in occupational health research, but not, to our knowledge, in disaster research. A PAR framework was incorporated into the World Trade Center evacuation study, which was designed to identify the individual, organizational, and structural (environmental) factors that affected evacuation from the World Trade Center Towers 1 and 2 on September 11, 2001. PAR teams-comprising World Trade Center evacuees, study investigators, and expert consultants-worked collaboratively to develop a set of recommendations designed to facilitate evacuation from high-rise office buildings and reduce risk of injury among evacuees. Two PAR teams worked first separately and then collectively to identify data-driven strategies for improvement of high-rise building evacuation. The teams identified interventions targeting individual, organizational, and structural (environmental) barriers to safe and rapid evacuation. PAR teams were effective in identifying numerous feasible and cost-effective strategies for improvement of high-rise emergency preparedness and evacuation. This approach may have utility in other workplace disaster prevention planning and response programs.

The significance of a small, level-3 'semi evacuation' hospital in a terrorist attack in a nearby town.

PubMed

Pinkert, Moshe; Leiba, Adi; Zaltsman, Eilon; Erez, Onn; Blumenfeld, Amir; Avinoam, Shkolnick; Laor, Daniel; Schwartz, Dagan; Goldberg, Avishay; Levi, Yehezkel; Bar-Dayan, Yaron

2007-09-01

Terrorist attacks can occur in remote areas causing mass-casualty incidents MCIs far away from level-1 trauma centres. This study draws lessons from an MCI pertaining to the management of primary and secondary evacuation and the operational mode practiced. Data was collected from formal debriefings during and after the event, and the medical response, interactions and main outcomes analysed using Disastrous Incidents Systematic Analysis through Components, Interactions and Results (DISAST-CIR) methodology. A total of 112 people were evacuated from the scene-66 to the nearby level 3 Laniado hospital, including the eight critically and severely injured patients. Laniado hospital was instructed to act as an evacuation hospital but the flow of patients ended rapidly and it was decided to admit moderately injured victims. We introduce a novel concept of a 'semi-evacuation hospital'. This mode of operation should be selected for small-scale events in which the evacuation hospital has hospitalization capacity and is not geographically isolated. We suggest that level-3 hospitals in remote areas should be prepared and drilled to work in semi-evacuation mode during MCIs.

How to simulate pedestrian behaviors in seismic evacuation for vulnerability reduction of existing buildings

NASA Astrophysics Data System (ADS)

Quagliarini, Enrico; Bernardini, Gabriele; D'Orazio, Marco

2017-07-01

Understanding and representing how individuals behave in earthquake emergencies would be essentially to assess the impact of vulnerability reduction strategies on existing buildings in seismic areas. In fact, interactions between individuals and the scenario (modified by the earthquake occurrence) are really important in order to understand the possible additional risks for people, especially during the evacuation phase. The current approach is based on "qualitative" aspects, in order to define best practice guidelines for Civil Protection and populations. On the contrary, a "quantitative" description of human response and evacuation motion in similar conditions is urgently needed. Hence, this work defines the rules for pedestrians' earthquake evacuation in urban scenarios, by taking advantages of previous results of real-world evacuation analyses. In particular, motion laws for pedestrians is defined by modifying the Social Force model equation. The proposed model could be used for evaluating individuals' evacuation process and so for defining operative strategies for interferences reduction in critical urban fabric parts (e.g.: interventions on particular buildings, evacuation strategies definition, city parts projects).

Selfishness- and Selflessness-based models of pedestrian room evacuation

NASA Astrophysics Data System (ADS)

Song, Xiao; Ma, Liang; Ma, Yaofei; Yang, Chen; Ji, Hang

2016-04-01

Some pedestrian evacuation studies have employed game strategy to deal with moving conflicts involving two or three pedestrians. However, most of these have simply presented game strategies for pedestrians without analyzing the reasons why they choose to defect or cooperate. We believe that selfish and selfless behaviors are two main factors that should be considered in evacuation. In addition to these behaviors, human emotions such as sympathy and behaviors such as vying were also taken into account to investigate their impacts on pedestrians' strategies. Moreover, an essential objective factor, the building design factor of door width was tested and analyzed. Experimental results showed that the sense of self leads to more defectors and a longer evacuation time. However, sympathy does some good, leading to more cooperators and a shorter evacuation time. Moreover, the exit door width is an essential factor of the evacuation efficiency. When the width was less than 6 cells in a rectangular room with a size greater than 50 × 50, the evacuation time greatly decreased when the width increased. However, this effect was less obvious when the width increased.

Tsunami evacuation plans for future megathrust earthquakes in Padang, Indonesia, considering stochastic earthquake scenarios

NASA Astrophysics Data System (ADS)

Muhammad, Ario; Goda, Katsuichiro; Alexander, Nicholas A.; Kongko, Widjo; Muhari, Abdul

2017-12-01

This study develops tsunami evacuation plans in Padang, Indonesia, using a stochastic tsunami simulation method. The stochastic results are based on multiple earthquake scenarios for different magnitudes (Mw 8.5, 8.75, and 9.0) that reflect asperity characteristics of the 1797 historical event in the same region. The generation of the earthquake scenarios involves probabilistic models of earthquake source parameters and stochastic synthesis of earthquake slip distributions. In total, 300 source models are generated to produce comprehensive tsunami evacuation plans in Padang. The tsunami hazard assessment results show that Padang may face significant tsunamis causing the maximum tsunami inundation height and depth of 15 and 10 m, respectively. A comprehensive tsunami evacuation plan - including horizontal evacuation area maps, assessment of temporary shelters considering the impact due to ground shaking and tsunami, and integrated horizontal-vertical evacuation time maps - has been developed based on the stochastic tsunami simulation results. The developed evacuation plans highlight that comprehensive mitigation policies can be produced from the stochastic tsunami simulation for future tsunamigenic events.

Using Three-Dimensional Printing to Fabricate a Tubing Connector for Dilation and Evacuation.

PubMed

Stitely, Michael L; Paterson, Helen

2016-02-01

This is a proof-of-concept study to show that simple instrumentation problems encountered in surgery can be solved by fabricating devices using a three-dimensional printer. The device used in the study is a simple tubing connector fashioned to connect two segments of suction tubing used in a surgical procedure where no commercially available product for this use is available through our usual suppliers in New Zealand. A cylindrical tubing connector was designed using three-dimensional printing design software. The tubing connector was fabricated using the Makerbot Replicator 2X three-dimensional printer. The connector was used in 15 second-trimester dilation and evacuation procedures. Data forms were completed by the primary operating surgeon. Descriptive statistics were used with the expectation that the device would function as intended in all cases. The three-dimensional printed tubing connector functioned as intended in all 15 instances. Commercially available three-dimensional printing technology can be used to overcome simple instrumentation problems encountered during gynecologic surgical procedures.

Prototype development and demonstration for response, emergency staging, communications, uniform management, and evacuation (R.E.S.C.U.M.E.) : R.E.S.C.U.M.E. final functional and performance requirements.

DOT National Transportation Integrated Search

2014-01-01

This document provides the high-level functional and performance requirements for the Prototype Development and Demonstration of a R.E.S.C.U.M.E. system. The requirements included in this document are based upon those that can be found in previous R....

Using highways during notice evacuations operations.

DOT National Transportation Integrated Search

2006-12-01

Evacuations may involve hundreds or hundreds of thousands of people. regardless of the numbers, in each and every instance, the transportation network plays a key role in evacuating people out of harms way. recognizing the unique challenges posed ...

Evacuation and rescue in automated guideway transit. Volume 2 : guidebook

DOT National Transportation Integrated Search

1979-12-01

Evacuation and rescue are significant problems in all transportation systems. : Serious injuries and loss of life can result from situations in which inadequate : means of evacuating and rescuing passengers exist. In conventional transporlation : sys...

Evacuation and Rescue in Automated Guideway Transit : Volume 2. Guidebook.

DOT National Transportation Integrated Search

1979-12-01

Evacuation and rescue are significant problems in all transportation systems. Serious injuries and loss of life can result from situations in which inadequate means of evacuating and rescuing passengers exist. In conventional transporlation systems, ...

Evacuation simulation with consideration of obstacle removal and using game theory

NASA Astrophysics Data System (ADS)

Lin, Guan-Wen; Wong, Sai-Keung

2018-06-01

In this paper, we integrate a cellular automaton model with game theory to simulate crowd evacuation from a room with consideration of obstacle removal. The room has one or more exits, one of which is blocked by obstacles. The obstacles at the exit can be removed by volunteers. We investigate the cooperative and defective behaviors of pedestrians during evacuation. The yielder game and volunteer's dilemma game are employed to resolve interpedestrian conflict. An anticipation floor field is proposed to guide the pedestrians to avoid obstacles that are being removed. We conducted experiments to determine how a variety of conditions affect overall crowd evacuation and volunteer evacuation times. The conditions were the start time of obstacle removal, number of obstacles, placement of obstacles, time spent in obstacle removal, strength of the anticipation floor field, and obstacle visibility distance. We demonstrate how reciprocity can be achieved among pedestrians and increases the efficiency of the entire evacuation process.

Usability and Visual Communication for Southern California Tsunami Evacuation Information: The importance of information design in disaster risk management

NASA Astrophysics Data System (ADS)

Jaenichen, C.; Schandler, S.; Wells, M.; Danielsen, T.

2015-12-01

Evacuation behavior, including participation and response, is rarely an individual and isolated process and the outcomes are usually systemic. Ineffective evacuation information can easily attribute to delayed evacuation response. Delays increase demands on already extended emergency personal, increase the likelihood of traffic congestion, and can cause harm to self and property. From an information design perspective, addressing issues in cognitive recall and emergency psychology, this case study examines evacuation messaging including written, audio, and visual presentation of information, and describes the application of design principles and role of visual communication for Southern California tsunami evacuation outreach. The niche of this project is the inclusion of cognitive processing as the driving influence when making formal design decisions and measurable data from a 4-year cognitive recall study to support the solution. Image included shows a tsunami evacaution map before and after the redesign.

NIRS external dose estimation system for Fukushima residents after the Fukushima Dai-ichi NPP accident

NASA Astrophysics Data System (ADS)

Akahane, Keiichi; Yonai, Shunsuke; Fukuda, Shigekazu; Miyahara, Nobuyuki; Yasuda, Hiroshi; Iwaoka, Kazuki; Matsumoto, Masaki; Fukumura, Akifumi; Akashi, Makoto

2013-04-01

The great east Japan earthquake and subsequent tsunamis caused Fukushima Dai-ichi Nuclear Power Plant (NPP) accident. National Institute of Radiological Sciences (NIRS) developed the external dose estimation system for Fukushima residents. The system is being used in the Fukushima health management survey. The doses can be obtained by superimposing the behavior data of the residents on the dose rate maps. For grasping the doses, 18 evacuation patterns of the residents were assumed by considering the actual evacuation information before using the survey data. The doses of the residents from the deliberate evacuation area were relatively higher than those from the area within 20 km radius. The estimated doses varied from around 1 to 6 mSv for the residents evacuated from the representative places in the deliberate evacuation area. The maximum dose in 18 evacuation patterns was estimated to be 19 mSv.

Household evacuation characteristics in American Samoa during the 2009 Samoa Islands tsunami

USGS Publications Warehouse

Apatu, Emma J. I.; Gregg, Chris E.; Wood, Nathan J.; Wang, Liang

2016-01-01

Tsunamis represent significant threats to human life and development in coastal communities. This quantitative study examines the influence of household characteristics on evacuation actions taken by 211 respondents in American Samoa who were at their homes during the 29 September 2009 Mw 8.1 Samoa Islands earthquake and tsunami disaster. Multiple logistic regression analysis of survey data was used to examine the association between evacuation and various household factors. Findings show that increases in distance to shoreline were associated with a slightly decreased likelihood of evacuation, whereas households reporting higher income had an increased probability of evacuation. The response in American Samoa was an effective one, with only 34 fatalities in a tsunami that reached shore in as little as 15 minutes. Consequently, future research should implement more qualitative study designs to identify event and cultural specific determinants of household evacuation behaviour to local tsunamis.

Study on queueing behavior in pedestrian evacuation by extended cellular automata model

NASA Astrophysics Data System (ADS)

Hu, Jun; You, Lei; Zhang, Hong; Wei, Juan; Guo, Yangyong

2018-01-01

This paper proposes a pedestrian evacuation model for effective simulation of evacuation efficiency based on extended cellular automata. In the model, pedestrians' momentary transition probability to a target position is defined in terms of the floor field and queueing time, and the critical time is defined as the waiting time threshold in a queue. Queueing time and critical time are derived using Fractal Brownian Motion through analysis of pedestrian arrival characteristics. Simulations using the platform and actual evacuations were conducted to study the relationships among system evacuation time, average system velocity, pedestrian density, flow rate, and critical time. The results demonstrate that at low pedestrian density, evacuation efficiency can be improved through adoption of the shortest route strategy, and critical time has an inverse relationship with average system velocity. Conversely, at higher pedestrian densities, it is better to adopt the shortest queueing time strategy, and critical time is inversely related to flow rate.

NIRS external dose estimation system for Fukushima residents after the Fukushima Dai-ichi NPP accident.

PubMed

Akahane, Keiichi; Yonai, Shunsuke; Fukuda, Shigekazu; Miyahara, Nobuyuki; Yasuda, Hiroshi; Iwaoka, Kazuki; Matsumoto, Masaki; Fukumura, Akifumi; Akashi, Makoto

2013-01-01

The great east Japan earthquake and subsequent tsunamis caused Fukushima Dai-ichi Nuclear Power Plant (NPP) accident. National Institute of Radiological Sciences (NIRS) developed the external dose estimation system for Fukushima residents. The system is being used in the Fukushima health management survey. The doses can be obtained by superimposing the behavior data of the residents on the dose rate maps. For grasping the doses, 18 evacuation patterns of the residents were assumed by considering the actual evacuation information before using the survey data. The doses of the residents from the deliberate evacuation area were relatively higher than those from the area within 20 km radius. The estimated doses varied from around 1 to 6 mSv for the residents evacuated from the representative places in the deliberate evacuation area. The maximum dose in 18 evacuation patterns was estimated to be 19 mSv.

[Association between evacuation condition and habitual physical activity in Great East Japan Earthquake evacuees: The Fukushima Health Management Survey].

PubMed

Nagai, Masato; Ohira, Tetsuya; Yasumura, Seiji; Takahashi, Hideto; Yuki, Michiko; Nakano, Hironori; Wen, Zhang; Yabe, Hirooki; Ohtsuru, Akira; Maeda, Masaharu; Takase, Kanae

2016-01-01

Objectives: Prevalence of life-style disease has increased dramatically in evacuees due to the Great East Japan Earthquake. One reason may be that physical activity level decreased from life environment changes due to evacuation. However, associations between evacuation condition and habitual physical activity have not been studied. We examined this association in Fukushima residents who participated in the Fukushima Health Management Survey. Methods: In this study, 37,843 evacuees from 13 municipal evacuation zones from the nuclear-power accident caused by the Great East Japan Earthquake, born before April 1, 1995, were included in the analysis. Evacuation condition was defined by disaster living place (13 zones), evacuation place (inside or outside the prefecture), and current living status (evacuation shelter or temporary housing, rental housing/ apartment, and relative's home or own home). Habitual physical activity was defined from self-administered questionnaires as participants who responded "almost every day" and "2-4 times/week" of regular exercise. In the analysis, habitual physical activity prevalence was aggregated by gender and variables (living place in the disaster, evacuation place, and current living status). Prevalence was adjusted for age, disaster living place, evacuation place, and current living status by standard analysis of covariance methods. Results: Adjusted prevalences of habitual physical activity were: men, 27.9-46.5%; women, 27.0-43.7% in each disaster living place. The differences were 18.6% point in men and 16.7% point in women. For evacuation place, physical activity outside the prefecture for men (37.7%) and inside the prefecture for women (32.1%) were higher, but those differences were only 2.2% point and 1.8% point in men and women, respectively. For current living status, physical activity of those in rental housing/ apartment was the lowest; evacuation shelter or temporary housing was the highest in both genders (men: 38.9%, women: 36.7%). Compared with residents in evacuation shelter or temporary housing, those in rental housing/apartment were 5.4% point and 7.1% point lower and those in relative's home or own home were 2.0% point and 4.2% point lower in men and women. Conclusion: Habitual physical activity in residents who lived in 13 municipal evacuation zone differed by disaster living place and current living status, while it was similar regardless of placement in the prefecture. In particular, prevalence was the lowest in participants who lived in rental housing/ apartment. We need to plan and perform additional life-style disease prevention strategies for participants who become isolated.

Integration of social vulnerability into emergency management plans: designing of evacuation routes against flood disasters

NASA Astrophysics Data System (ADS)

Aroca-Jimenez, Estefanía; Bodoque, Jose Maria; Garcia, Juan Antonio; Diez-Herrero, Andres

2017-04-01

Flash floods are highly spatio-temporal localized flood events characterized by reaching a high peak flow in a very short period of time, i.e., generally with times of concentration lower than six hours. Its short duration, which limits or even voids any warning time, means that flash floods are considered to be one of the most destructive natural hazards with the greatest capacity to generate risk, either in terms of the number of people affected globally or the proportion of individual fatalities. The above highlights the importance of a realistic and appropriate design of evacuation strategies in order to reduce flood-related losses, being evacuation planning considered of critical importance for disaster management. Traditionally, evacuation maps have been based on flood-prone areas, shelters or emergency residences location and evacuation routes information. However, evacuation plans rarely consider the spatial distribution of vulnerable population (i.e., people with special needs, mobility constraints or economic difficulties), which usually require assistance from emergency responders. The goal of this research is to elaborate an evacuation map against the occurrence of flash floods by combining geographic information (e.g. roads, health facilities location, sanitary helicopters) and social vulnerability patterns, which are previously obtained from socioeconomic variables (e.g. population, unemployment, dwelling characteristics). To do this, ArcGis Network Analyst tool is used, which allows to calculate the optimal evacuation routes. The methodology proposed here is implemented in the region of Castilla y León (94,230 km2). Urban areas prone to flash flooding are identified taking into account the following requirements: i) city centers are crossed by rivers or streams with a longitudinal slope higher than 0.01 m m-1; ii) city centers are potentially affected by flash floods; and iii) city centers are affected by an area with low or exceptional probability of flooding (i.e., 500-year flood). A total of 3 evacuation routes were designed and automatically traced for each of the 39 urban areas identified as interest, considering the nearest: i) health facility, ii) hospital; and iii) evacuation area (i.e. sports halls or any other). The suitable elaboration of evacuation plans is really important in small mountainous areas prone to flash flooding as they are managed by local organisms where available economic resources are often limited. Furthermore, the short response time obliges emergency responders to act efficiently, which requires the design of evacuation plans taking into account certain social characteristics for evacuation routes designing.

3D Building Evacuation Route Modelling and Visualization

NASA Astrophysics Data System (ADS)

Chan, W.; Armenakis, C.

2014-11-01

The most common building evacuation approach currently applied is to have evacuation routes planned prior to these emergency events. These routes are usually the shortest and most practical path from each building room to the closest exit. The problem with this approach is that it is not adaptive. It is not responsively configurable relative to the type, intensity, or location of the emergency risk. Moreover, it does not provide any information to the affected persons or to the emergency responders while not allowing for the review of simulated hazard scenarios and alternative evacuation routes. In this paper we address two main tasks. The first is the modelling of the spatial risk caused by a hazardous event leading to choosing the optimal evacuation route for a set of options. The second is to generate a 3D visual representation of the model output. A multicriteria decision making (MCDM) approach is used to model the risk aiming at finding the optimal evacuation route. This is achieved by using the analytical hierarchy process (AHP) on the criteria describing the different alternative evacuation routes. The best route is then chosen to be the alternative with the least cost. The 3D visual representation of the model displays the building, the surrounding environment, the evacuee's location, the hazard location, the risk areas and the optimal evacuation pathway to the target safety location. The work has been performed using ESRI's ArcGIS. Using the developed models, the user can input the location of the hazard and the location of the evacuee. The system then determines the optimum evacuation route and displays it in 3D.

An Integrated Approach to Modeling Evacuation Behavior

DOT National Transportation Integrated Search

2011-02-01

A spate of recent hurricanes and other natural disasters have drawn a lot of attention to the evacuation decision of individuals. Here we focus on evacuation models that incorporate two economic phenomena that seem to be increasingly important in exp...

The U.S. Air Force Aeromedical Evacuation Mission: A Mission for the Air Reserve Components

DTIC Science & Technology

2016-02-01

AU/ACSC/2016 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY THE U.S. AIR FORCE AEROMEDICAL EVACUATION MISSION: A MISSION FOR THE AIR RESERVE...Aeromedical Evacuation ............................................................................................................. 7 The Current Problem...13 Evaluation

Evacuation transportation management : task five : operational concept.

DOT National Transportation Integrated Search

2009-06-26

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

Evacuation transportation management. Task five, Operational concept

DOT National Transportation Integrated Search

2006-01-01

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

A Comparison of the Nursing Home Evacuation Experience between Hurricanes Katrina (2005) and Gustav (2008)

PubMed Central

Blanchard, Gary; Dosa, David

2009-01-01

Background One of the tragic legacies of Hurricane Katrina was the loss of life among Louisiana (LA) nursing home (NH) residents. Katrina revealed a staggering lack of emergency preparation and understanding of how to safely evacuate frail populations. Three years later, LA braced for Hurricane Gustav, a storm heralded to rival Katrina's power. Though its magnitude of destruction ultimately paled to Katrina, the warnings and predicted path preceding Gustav yielded a process of NH evacuations similar to Katrina. The goal of this paper was to ascertain whether NH administrative directors (ADs) felt more prepared to evacuate before Gustav. Methods In 2006, Dosa, et. al. (JAMDA, 3/07), interviewed 20 NH ADs by qualitative telephone survey to evaluate their lessons learned from Katrina. Administrators at these 20 participating nursing homes were contacted and asked to participate in a follow-up survey to compare hurricane preparedness between 2005 and 2008. Specifically, ADs were asked if they evacuated prior to Gustav, their destination, and about logistical issues with evacuation (e.g., transportation, injuries). ADs were asked to rate their confidence with state assistance, hurricane transportation, and evacuation preparedness on a 10-point scale (10=most confident) and compare their preparedness to Katrina. Results Sixteen of the 20 NHs that participated in 2006 agreed to be surveyed – 11 of whom held the same position before Katrina. Unlike Katrina, when only 45% evacuated prior to the storm, all 16 NHs evacuated before Gustav. (56% to another NH and 46% to a church, gym, college, or other facility). Overall, ADs rated their confidence in preparedness for Gustav as a mean of 8.3 (range 5 to 10) – compared with a mean of 5.4 (range 3 to 8) for Katrina, a 54% improvement. Of the 11 ADs employed pre-Katrina, 73% reported improved collaboration with the state and 55% noted improved transportation. Nevertheless, seven ADs noted significant logistical problems during evacuation (mostly transportation); four noted resident injuries (two hip fractures, one traumatic fall, and one cerebrovascular accident); and two noted resident post-traumatic stress. Conclusions NH ADs felt more prepared to evacuate their residents for Gustav, owing partly to improved communication and collaboration with state agencies; however, significant morbidity and logistical problems remain with evacuating frail NH residents before hurricanes. PMID:19883887

A comparison of the nursing home evacuation experience between hurricanes katrina (2005) and gustav (2008).

PubMed

Blanchard, Gary; Dosa, David

2009-11-01

One of the tragic legacies of Hurricane Katrina was the loss of life among Louisiana (LA) nursing home (NH) residents. Katrina revealed a staggering lack of emergency preparation and understanding of how to safely evacuate frail populations. Three years later, LA braced for Hurricane Gustav, a storm heralded to rival Katrina's power. Although its magnitude of destruction ultimately paled to Katrina, the warnings and predicted path preceding Gustav yielded a process of NH evacuations similar to Katrina. The goal of this article was to ascertain whether NH administrative directors (ADs) felt more prepared to evacuate before Gustav. In 2006, Dosa et al(5) (J Am Med Dir Assoc, 3/07), interviewed 20 NH ADs by qualitative telephone survey to evaluate their lessons learned from Katrina. Administrators at these 20 participating nursing homes were contacted and asked to participate in a follow-up survey to compare hurricane preparedness between 2005 and 2008. Specifically, ADs were asked if they evacuated before Gustav, their destination, and about logistical issues with evacuation (eg, transportation, injuries). ADs were asked to rate their confidence with state assistance, hurricane transportation, and evacuation preparedness on a 10-point scale (10=most confident) and compare their preparedness to Katrina. Sixteen of the 20 NHs that participated in 2006 agreed to be surveyed-11 of whom held the same position before Katrina. Unlike Katrina, when only 45% evacuated before the storm, all 16 NHs evacuated before Gustav (56% to another NH and 46% to a church, gym, college, or other facility). Overall, ADs rated their confidence in preparedness for Gustav as a mean of 8.3 (range 5 to 10) compared with a mean of 5.4 (range 3 to 8) for Katrina, a 54% improvement. Of the 11 ADs employed pre-Katrina, 73% reported improved collaboration with the state and 55% noted improved transportation. Nevertheless, 7 ADs noted significant logistical problems during evacuation (mostly transportation); 4 noted resident injuries (2 hip fractures, 1 traumatic fall, and 1 cerebrovascular accident); and 2 noted resident posttraumatic stress. NH ADs felt more prepared to evacuate their residents for Gustav, owing partly to improved communication and collaboration with state agencies; however, significant morbidity and logistical problems remain with evacuating frail NH residents before hurricanes.

Environmental chamber for in situ dynamic control of temperature and relative humidity during x-ray scattering

NASA Astrophysics Data System (ADS)

Salas-de la Cruz, David; Denis, Jeffrey G.; Griffith, Matthew D.; King, Daniel R.; Heiney, Paul A.; Winey, Karen I.

2012-02-01

We have designed, constructed, and evaluated an environmental chamber that has in situ dynamic control of temperature (25 to 90 °C) and relative humidity (0% to 95%). The compact specimen chamber is designed for x-ray scattering in transmission with an escape angle of 2θ = ±30°. The specimen chamber is compatible with a completely evacuated system such as the Rigaku PSAXS system, in which the specimen chamber is placed inside a larger evacuated chamber (flight path). It is also compatible with x-ray systems consisting of evacuated flight tubes separated by small air gaps for sample placement. When attached to a linear motor (vertical displacement), the environmental chamber can access multiple sample positions. The temperature and relative humidity inside the specimen chamber are controlled by passing a mixture of dry and saturated gas through the chamber and by heating the chamber walls. Alternatively, the chamber can be used to control the gaseous environment without humidity. To illustrate the value of this apparatus, we have probed morphology transformations in Nafion® membranes and a polymerized ionic liquid as a function of relative humidity in nitrogen.

Suicide Rates in Evacuation Areas After the Fukushima Daiichi Nuclear Disaster.

PubMed

Orui, Masatsugu; Suzuki, Yuriko; Maeda, Masaharu; Yasumura, Seiji

2018-04-05

Associations between nuclear disasters and suicide have been examined to a limited extent. To clarify the suicide rates in evacuation areas after the nuclear disaster in Fukushima, which occurred in March 2011. This descriptive study used monthly data from vital statistics between March 2009 and December 2015. Suicide rates in areas to which evacuation orders had been issued, requiring across-the-board, compulsory evacuation of residents from the entire or part of municipalities, were obtained and compared with the national average. Male suicide rates in evacuation areas increased significantly immediately after the disaster, and then began to increase again 4 years after the disaster. Female suicide rates declined slightly during the first year and then increased significantly over the subsequent 3-year period. Moreover, male rates in areas where evacuation orders were issued for the total area declined over the course of approximately 2 years, but then began to increase thereafter. Analysis by age revealed postdisaster male rates in evacuation areas decreased for those aged 50-69 years and increased for those aged ≤ 29 years and ≥ 70 years. The number of suicides among females and the female population in the evacuation area was small. Our findings suggest the need to keep in mind that, when providing post-disaster mental health services, suicide rates can eventually increase even if they initially decrease.

Leveraging Twitter to gauge evacuation compliance: Spatiotemporal analysis of Hurricane Matthew.

PubMed

Martín, Yago; Li, Zhenlong; Cutter, Susan L

2017-01-01

Hurricane Matthew was the deadliest Atlantic storm since Katrina in 2005 and prompted one of the largest recent hurricane evacuations along the Southeastern coast of the United States. The storm and its projected landfall triggered a massive social media reaction. Using Twitter data, this paper examines the spatiotemporal variability in social media response and develops a novel approach to leverage geotagged tweets to assess the evacuation responses of residents. The approach involves the retrieval of tweets from the Twitter Stream, the creation and filtering of different datasets, and the statistical and spatial processing and treatment to extract, plot and map the results. As expected, peak Twitter response was reached during the pre-impact and preparedness phase, and decreased abruptly after the passage of the storm. A comparison between two time periods-pre-evacuation (October 2th-4th) and post-evacuation (October 7th-9th)-indicates that 54% of Twitter users moved away from the coast to a safer location, with observed differences by state on the timing of the evacuation. A specific sub-state analysis of South Carolina illustrated overall compliance with evacuation orders and detailed information on the timing of departure from the coast as well as the destination location. These findings advance the use of big data and citizen-as-sensor approaches for public safety issues, providing an effective and near real-time alternative for measuring compliance with evacuation orders.

Hurricanes Katrina and Rita and the Department of Veterans Affairs: a conceptual model for understanding the evacuation of nursing homes.

PubMed

Dobalian, Aram; Claver, Maria; Fickel, Jacqueline J

2010-01-01

Hurricanes Katrina and Rita exposed significant flaws in US preparedness for catastrophic events and the nation's capacity to respond to them. These flaws were especially evident in the affected disaster areas' nursing homes, which house a particularly vulnerable population of frail older adults. Although evacuation of a healthcare facility is a key preparedness activity, there is limited research on factors that lead to effective evacuation. Our review of the literature on evacuation is focused on developing a conceptual framework to study future evacuations rather than as a comprehensive assessment of prior work. This paper summarizes what is known thus far about disaster response activities of nursing homes following natural and human-caused disasters, describes a conceptual model to guide future inquiry regarding this topic, and suggests future areas of research to further understand the decision-making process of nursing home facilitators regarding evacuating nursing home residents. To demonstrate the utility of the conceptual model and to provide guidance about effective practices and procedures, this paper focuses on the responses of Veterans Health Administration (VHA) nursing homes to the 2 hurricanes. Quarantelli's conceptual framework, as modified by Perry and Mushkatel, is useful in guiding the development of central hypotheses related to the decision-making that occurred in VA nursing homes and other healthcare facilities following Hurricanes Katrina and Rita. However, we define evacuation somewhat differently to account for the fact that evacuation may, in some instances, be permanent. Thus, we propose modifying this framework to improve its applicability beyond preventive evacuation. We need to better understand how disaster plans can be adapted to meet the needs of frail elders and other residents in nursing homes. Moreover, we must address identified gaps in the scientific literature with respect to health outcomes by tracking outcomes over time. Information on health outcomes would allow administrators and others to more appropriately weigh the balance of risks and benefits associated with evacuation. Without this understanding of the relationship between evacuation and health outcomes, it is not possible to develop effective response plans that are tailored to meet the needs of nursing home residents. Copyright © 2010 S. Karger AG, Basel.

Emergency communications for evacuation (EVAC) in New Orleans impact assessment report.

DOT National Transportation Integrated Search

2015-05-01

This document constitutes the Impact Assessment Report for Emergency Communications for Evacuation (EVAC) in New Orleans. Response, Emergency Staging and Communications, Uniform Management, and Evacuation (R.E.S.C.U.M.E.) is a bundle of applications ...

Evacuation and rescue in automated guideway transit. Volume 1 : data collection, scenarios, and evaluation

DOT National Transportation Integrated Search

1979-12-01

Evacuation and rescue are significant problems in all transportation systems. Serious injuries and loss of life can result from situations in which inadequate means of evacuating and rescuing passengers exist. In conventional transportation systems, ...

Evacuation transportation management : task four: interview and survey results.

DOT National Transportation Integrated Search

2006-06-26

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

Using highways during evacuation operations for events with advance notice

DOT National Transportation Integrated Search

2006-12-01

This document constitutes the first of a primer series titled 'Routes to Effective Evacuation planning' and covers the use of the highway system during evacuation operations when advance planning is possible [...] This is a basic-level guide on condu...

Evacuation transportation management. Task four, Interview and survey results

DOT National Transportation Integrated Search

2006-01-01

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

"Operation Workload" : a study of passenger energy expenditure during an emergency evacuation.

DOT National Transportation Integrated Search

1989-03-01

In an earlier study at the Civil Aeromedical Institute, workloads were determined for passengers during an emergency evacuation. The evacuation tests were conducted in an orderly manner and were suggested as representative of a moderate workload. The...

Reasons for medical evacuations of soldiers serving in International Security Assistance Force (ISAF) operation in Afghanistan.

PubMed

Korzeniewski, Krzysztof; Gregulski, Robert

2014-01-01

The article presents the results of a research study into the reasons for medical evacuations of Polish military personnel taking part in the International Security Assistance Force (ISAF) operation in Afghanistan from 2007 to 2013. The authors have analysed medical records of 485 soldiers who were medically evacuated out of a combat zone in Afghanistan for battle injuries, non-battle injuries and diseases. Each medically evacuated Polish soldier was subjected to statistical analysis. The study population comprised 25,974 soldiers assigned to the Polish Military Contingent Afghanistan in the given period. From 2007 to 2013, 1.9% of the Polish military personnel (n = 485) participating in the ISAF operation in Afghanistan were evacuated for medical reasons before the scheduled termination of their contract. 40.6% of all medical evacuations were due to battle injuries, 32.4% due to non-battle injuries, and 27.0% due to diseases. ISAF is an example of a combat operation, in which battle injuries remain the leading health problem in mission participants. 3 of 4 Polish soldiers who were medically evacuated from Afghanistan were no longer fit for military service in the area of operations due to the traumas they had suffered.

Modeling hurricane evacuation traffic : evaluation of freeway contraflow evacuation initiation and termination point configurations.

DOT National Transportation Integrated Search

2010-06-01

Over the last five years, the departments of transportation in 12 coastal states threatened by hurricanes have developed plans for the implementation of contraflow traffic operations on freeways during evacuations. Contraflow involves the use of one ...

Modeling hurricane evacuation traffic : a mobile real-time traffic counter for monitoring hurricane evacuation traffic conditions.

DOT National Transportation Integrated Search

2006-04-01

In this research report, an investigation was conducted to identify a suitable traffic monitoring device for collecting traffic data during actual emergency evacuation conditions that may result from hurricanes in Louisiana. The study reviewed thorou...

A review of computer evacuation models and their data needs.

DOT National Transportation Integrated Search

1994-05-01

This document reviews the history and current status of computer models of the evacuation of an airliner cabin. Basic concepts upon which evacuation models are based are discussed, followed by a review of the Civil Aerospace Medical Institute s effor...

Integrating supply and demand aspects of transportation for mass evacuation under disasters.

DOT National Transportation Integrated Search

2009-10-15

This study seeks to address real-time operational needs in the context of the evacuation response problem by providing a capability to dynamically route vehicles under evacuation, thereby being responsive to the actual conditions unfolding in real-ti...

Modeling hurricane evacuation traffic : evaluation of freeway contraflow evacuation initiation and termination point configurations.

DOT National Transportation Integrated Search

2006-06-01

Over the last 5 years, the Departments of Transportation in 12 coastal states threatened by hurricanes have developed plans for the implementation of contraflow traffic operations on freeways during evacuations. Contraflow involves the use of one or ...

Development of a time-dependent hurricane evacuation model for the New Orleans area : [technical summary].

DOT National Transportation Integrated Search

2013-01-01

When hurricanes threaten coastal cities, the most eff ective strategy to mitigate mortality is to evacuate the population : at risk. However, public offi cials face several transportation challenges when managing evacuations from a large city : like ...

KAMEDO Report No. 92: Evacuation of Swedes from Lebanon--observational studies in connection with the war in Lebanon in summer 2006.

PubMed

Kulling, Per; Sigurdsson, Susannah; Hamberger, Bertil

2008-01-01

A large-scale armed conflict between Hezbollah and Israel in July 2006 caused the evacuation of a large number of Swedish residents from Lebanon. This report describes the evacuation throughout its various stages. Swedish authorities were prepared for an event of this type from the experience of the 2004 Asian tsunami disaster. Lessons learned from the management and medical care during the evacuations are presented in this report.

Integrated numerical modeling of a landslide early warning system in a context of adaptation to future climatic pressures

NASA Astrophysics Data System (ADS)

Khabarov, Nikolay; Huggel, Christian; Obersteiner, Michael; Ramírez, Juan Manuel

2010-05-01

Mountain regions are typically characterized by rugged terrain which is susceptible to different types of landslides during high-intensity precipitation. Landslides account for billions of dollars of damage and many casualties, and are expected to increase in frequency in the future due to a projected increase of precipitation intensity. Early warning systems (EWS) are thought to be a primary tool for related disaster risk reduction and climate change adaptation to extreme climatic events and hydro-meteorological hazards, including landslides. An EWS for hazards such as landslides consist of different components, including environmental monitoring instruments (e.g. rainfall or flow sensors), physical or empirical process models to support decision-making (warnings, evacuation), data and voice communication, organization and logistics-related procedures, and population response. Considering this broad range, EWS are highly complex systems, and it is therefore difficult to understand the effect of the different components and changing conditions on the overall performance, ultimately being expressed as human lives saved or structural damage reduced. In this contribution we present a further development of our approach to assess a landslide EWS in an integral way, both at the system and component level. We utilize a numerical model using 6 hour rainfall data as basic input. A threshold function based on a rainfall-intensity/duration relation was applied as a decision criterion for evacuation. Damage to infrastructure and human lives was defined as a linear function of landslide magnitude, with the magnitude modelled using a power function of landslide frequency. Correct evacuation was assessed with a ‘true' reference rainfall dataset versus a dataset of artificially reduced quality imitating the observation system component. Performance of the EWS using these rainfall datasets was expressed in monetary terms (i.e. damage related to false and correct evacuation). We applied this model to a landslide EWS in Colombia that is currently being implemented within a disaster prevention project. We evaluated the EWS against rainfall data with artificially introduced error and computed with multiple model runs the probabilistic damage functions depending on rainfall error. Then we modified the original precipitation pattern to reflect possible climatic changes e.g. change in annual precipitation as well as change in precipitation intensity with annual values remaining constant. We let the EWS model adapt for changed conditions to function optimally. Our results show that for the same errors in rainfall measurements the system's performance degrades with expected changing climatic conditions. The obtained results suggest that EWS cannot internally adapt to climate change and require exogenous adaptive measures to avoid increase in overall damage. The model represents a first attempt to integrally simulate and evaluate EWS under future possible climatic pressures. Future work will concentrate on refining model components and spatially explicit climate scenarios.

Spontaneous intracranial hemorrhage and multiple intracranial aneurysms in a patient with Roberts/SC phocomelia syndrome.

PubMed

Wang, Anthony C; Gemmete, Joseph J; Keegan, Catherine E; Witt, Cordelie E; Muraszko, Karin M; Than, Khoi D; Maher, Cormac O

2011-11-01

Roberts/SC phocomelia syndrome (RBS) is a rare but distinct genetic disorder with an autosomal recessive inheritance pattern. It has been associated with microcephaly, craniofacial malformation, cavernous hemangioma, encephalocele, and hydrocephalus. There are no previously reported cases of RBS with intracranial aneurysms. The authors report on a patient with a history of RBS who presented with a spontaneous posterior fossa hemorrhage. Multiple small intracranial aneurysms were noted on a preoperative CT angiogram. The patient underwent emergency craniotomy for evacuation of the hemorrhage. A postoperative angiogram confirmed the presence of multiple, distal small intracranial aneurysms.

Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet.

PubMed

Manichanh, Chaysavanh; Eck, Anat; Varela, Encarna; Roca, Joaquim; Clemente, José C; González, Antonio; Knights, Dan; Knight, Rob; Estrella, Sandra; Hernandez, Carlos; Guyonnet, Denis; Accarino, Anna; Santos, Javier; Malagelada, Juan-R; Guarner, Francisco; Azpiroz, Fernando

2014-03-01

To characterise the influence of diet on abdominal symptoms, anal gas evacuation, intestinal gas distribution and colonic microbiota in patients complaining of flatulence. Patients complaining of flatulence (n=30) and healthy subjects (n=20) were instructed to follow their usual diet for 3 days (basal phase) and to consume a high-flatulogenic diet for another 3 days (challenge phase). During basal phase, patients recorded more abdominal symptoms than healthy subjects in daily questionnaires (5.8±0.3 vs 0.4±0.2 mean discomfort/pain score, respectively; p=<0.0001) and more gas evacuations by an event marker (21.9±2.8 vs 7.4±1.0 daytime evacuations, respectively; p=0.0001), without differences in the volume of gas evacuated after a standard meal (262±22 and 265±25 mL, respectively). On flatulogenic diet, both groups recorded more abdominal symptoms (7.9±0.3 and 2.8±0.4 discomfort/pain, respectively), number of gas evacuations (44.4±5.3 and 21.7±2.9 daytime evacuations, respectively) and had more gas production (656±52 and 673±78 mL, respectively; p<0.05 vs basal diet for all). When challenged with flatulogenic diet, patients' microbiota developed instability in composition, exhibiting variations in the main phyla and reduction of microbial diversity, whereas healthy subjects' microbiota were stable. Taxa from Bacteroides fragilis or Bilophila wadsworthia correlated with number of gas evacuations or volume of gas evacuated, respectively. Patients complaining of flatulence have a poor tolerance of intestinal gas, which is associated with instability of the microbial ecosystem.

Making Multi-Level Tsunami Evacuation Playbooks Operational in California and Hawaii

NASA Astrophysics Data System (ADS)

Wilson, R. I.; Peterson, D.; Fryer, G. J.; Miller, K.; Nicolini, T.; Popham, C.; Richards, K.; Whitmore, P.; Wood, N. J.

2016-12-01

In the aftermath of the 2010 Chile, 2011 Japan, and 2012 Haida Gwaii tsunamis in California and Hawaii, coastal emergency managers requested that state and federal tsunami programs investigate providing more detailed information about the flood potential and recommended evacuation for distant-source tsunamis well ahead of their arrival time. Evacuation "Playbooks" for tsunamis of variable sizes and source locations have been developed for some communities in the two states, providing secondary options to an all or nothing approach for evacuation. Playbooks have been finalized for nearly 70% of the coastal communities in California, and have been drafted for evaluation by the communities of Honolulu and Hilo in Hawaii. A key component to determining a recommended level of evacuation during a distant-source tsunami and making the Playbooks operational has been the development of the "FASTER" approach, an acronym for factors that influence the tsunami flood hazard for a community: Forecast Amplitude, Storm, Tides, Error in forecast, and the Run-up potential. Within the first couple hours after a tsunami is generated, the FASTER flood elevation value will be computed and used to select the appropriate minimum tsunami phase evacuation "Playbook" for use by the coastal communities. The states of California and Hawaii, the tsunami warning centers, and local weather service offices are working together to deliver recommendations on the appropriate evacuation Playbook plans for communities to use prior to the arrival of a distant-source tsunami. These partners are working closely with individual communities on developing conservative and consistent protocols on the use of the Playbooks. Playbooks help provide a scientifically-based, minimum response for small- to moderate-size tsunamis which could reduce the potential for over-evacuation of hundreds of thousands of people and save hundreds of millions of dollars in evacuation costs for communities and businesses.

Developing Tsunami Evacuation Plans, Maps, And Procedures: Pilot Project in Central America

NASA Astrophysics Data System (ADS)

Arcos, N. P.; Kong, L. S. L.; Arcas, D.; Aliaga, B.; Coetzee, D.; Leonard, J.

2015-12-01

In the End-to-End tsunami warning chain, once a forecast is provided and a warning alert issued, communities must know what to do and where to go. The 'where to' answer would be reliable and practical community-level tsunami evacuation maps. Following the Exercise Pacific Wave 2011, a questionnaire was sent to the 46 Member States of Pacific Tsunami Warning System (PTWS). The results revealed over 42 percent of Member States lacked tsunami mass coastal evacuation plans. Additionally, a significant gap in mapping was exposed as over 55 percent of Member States lacked tsunami evacuation maps, routes, signs and assembly points. Thereby, a significant portion of countries in the Pacific lack appropriate tsunami planning and mapping for their at-risk coastal communities. While a variety of tools exist to establish tsunami inundation areas, these are inconsistent while a methodology has not been developed to assist countries develop tsunami evacuation maps, plans, and procedures. The International Tsunami Information Center (ITIC) and partners is leading a Pilot Project in Honduras demonstrating that globally standardized tools and methodologies can be applied by a country, with minimal tsunami warning and mitigation resources, towards the determination of tsunami inundation areas and subsequently community-owned tsunami evacuation maps and plans for at-risk communities. The Pilot involves a 1- to 2-year long process centered on a series of linked tsunami training workshops on: evacuation planning, evacuation map development, inundation modeling and map creation, tsunami warning & emergency response Standard Operating Procedures (SOPs), and conducting tsunami exercises (including evacuation). The Pilot's completion is capped with a UNESCO/IOC document so that other countries can replicate the process in their tsunami-prone communities.

What are the effects of having an illness or injury whilst deployed on post deployment mental health? A population based record linkage study of UK Army personnel who have served in Iraq or Afghanistan

PubMed Central

2012-01-01

Background The negative impact of sustaining an injury on a military deployment on subsequent mental health is well-documented, however, the relationship between having an illness on a military operation and subsequent mental health is unknown. Methods Population based study, linking routinely collected data of attendances at emergency departments in military hospitals in Iraq and Afghanistan [Operational Emergency Department Attendance Register (OpEDAR)], with data on 3896 UK Army personnel who participated in a military health study between 2007 and 2009 and deployed to Iraq or Afghanistan between 2003 to 2009. Results In total, 13.8% (531/3896) of participants had an event recorded on OpEDAR during deployment; 2.3% (89/3884) were medically evacuated. As expected, those medically evacuated for an injury were at increased risk of post deployment probable PTSD (odds ratio 4.27, 95% confidence interval 1.80-10.12). Less expected was that being medically evacuated for an illness was also associated with a similarly increased risk of probable PTSD (4.39, 1.60-12.07) and common mental disorders (2.79, 1.41-5.51). There was no association between having an OpEDAR event and alcohol misuse. Having an injury caused by hostile action was associated with increased risk of probable PTSD compared to those with a non-hostile injury (3.88, 1.15 to 13.06). Conclusions Personnel sustaining illnesses on deployment are just as, if not more, at risk of having subsequent mental health problems as personnel who have sustained an injury. Monitoring of mental health problems should consider those with illnesses as well as physical injuries. PMID:23095133

Variations in disaster evacuation behavior: public responses versus private sector executive decision-making processes.

PubMed

Drabek, T E

1992-06-01

Data obtained from 65 executives working for tourism firms in three sample communities permitted comparison with the public warning response literature regarding three topics: disaster evacuation planning, initial warning responses, and disaster evacuation behavior. Disaster evacuation planning was reported by nearly all of these business executives, although it was highly variable in content, completeness, and formality. Managerial responses to post-disaster warnings paralleled the type of complex social processes that have been documented within the public response literature, except that warning sources and confirmation behavior were significantly affected by contact with authorities. Five key areas of difference were discovered in disaster evacuation behavior pertaining to: influence of planning, firm versus family priorities, shelter selection, looting concerns, and media contacts.

Role of pelvic floor in lower urinary tract function.

PubMed

Chermansky, Christopher J; Moalli, Pamela A

2016-10-01

The pelvic floor plays an integral part in lower urinary tract storage and evacuation. Normal urine storage necessitates that continence be maintained with normal urethral closure and urethral support. The endopelvic fascia of the anterior vaginal wall, its connections to the arcus tendineous fascia pelvis (ATFP), and the medial portion of the levator ani muscles must remain intact to provide normal urethral support. Thus, normal pelvic floor function is required for urine storage. Normal urine evacuation involves a series of coordinated events, the first of which involves complete relaxation of the external urethral sphincter and levator ani muscles. Acquired dysfunction of these muscles will initially result in sensory urgency and detrusor overactivity; however, with time the acquired voiding dysfunction can result in intermittent urine flow and incomplete bladder emptying, progressing to urinary retention in severe cases. This review will start with a discussion of normal pelvic floor anatomy and function. Next various injuries to the pelvic floor will be reviewed. The dysfunctional pelvic floor will be covered subsequently, with a focus on levator ani spasticity and stress urinary incontinence (SUI). Finally, future research directions of the interaction between the pelvic floor and lower urinary tract function will be discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

50 CFR 38.4 - Authorized functions, powers, and duties.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Investigation of accidents and offenses; (e) Custody and disposal of lost or abandoned property; (f) Regulation of aircraft and boat traffic and safety; (g) Imposition of quarantines; (h) Evacuation of hazardous... person from the Midway Atoll National Wildlife Refuge for cause; (k) Regulation of vehicle traffic and...

A methodology for evacuation design for urban areas: theoretical aspects and experimentation

NASA Astrophysics Data System (ADS)

Russo, F.; Vitetta, A.

2009-04-01

This paper proposes an unifying approach for the simulation and design of a transportation system under conditions of incoming safety and/or security. Safety and security are concerned with threats generated by very different factors and which, in turn, generate emergency conditions, such as the 9/11, Madrid and London attacks, the Asian tsunami, and the Katrina hurricane; just considering the last five years. In transportation systems, when exogenous events happen and there is a sufficient interval time between the instant when the event happens and the instant when the event has effect on the population, it is possible to reduce the negative effects with the population evacuation. For this event in every case it is possible to prepare with short and long term the evacuation. For other event it is possible also to plan the real time evacuation inside the general risk methodology. The development of models for emergency conditions in transportation systems has not received much attention in the literature. The main findings in this area are limited to only a few public research centres and private companies. In general, there is no systematic analysis of the risk theory applied in the transportation system. Very often, in practice, the vulnerability and exposure in the transportation system are considered as similar variables, or in other worse cases the exposure variables are treated as vulnerability variables. Models and algorithms specified and calibrated in ordinary conditions cannot be directly applied in emergency conditions under the usual hypothesis considered. This paper is developed with the following main objectives: (a) to formalize the risk problem with clear diversification (for the consequences) in the definition of the vulnerability and exposure in a transportation system; thus the book offers improvements over consolidated quantitative risk analysis models, especially transportation risk analysis models (risk assessment); (b) to formalize a system of models for evacuation simulation; (c) to calibrate and validate system of model for evacuation simulation from a real experimentation. In relation to the proposed objectives in this paper: (a) a general framework about risk analysis is reported in the first part, with specific methods and models to analyze urban transportation system performances in emergency conditions when exogenous phenomena occur and for the specification of the risk function; (b) a formulation of the general evacuation problem in the standard simulation context of "what if" approach is specified in the second part with reference to the model considered for the simulation of transportation system in ordinary condition; (c) a set of models specified in the second part are calibrated and validated from a real experimentation in the third part. The experimentation was developed in the central business district of an Italian village and about 1000 inhabitants were evacuated, in order to construct a complete data-base. Our experiment required that socioeconomic information (population, number employed, public buildings, schools, etc.) and ‎transport supply characteristics (infrastructures, etc.) be measured before and during experimentation. The real data of evacuation were recorded with 30 video cameras for laboratory analysis. The results are divided into six strictly connected tasks: Demand models; Supply and supply-demand interaction models for users; Simulation of refuge areas for users; Design of path choice models for emergency vehicles; Pedestrian outflow models in a building; Planning process and guidelines.

Emergency evacuation study for the Greater Jackson Area : evacuation traffic from New Orleans.

DOT National Transportation Integrated Search

2011-05-21

In response to both natural and man-made disasters, more and more emergency evacuation plans have been put : forward and consistently aims to move a large disaster affected population through a highway network towards safer : areas as quickly and eff...

Dual effects of pedestrian density on emergency evacuation

NASA Astrophysics Data System (ADS)

Ma, Yi; Lee, Eric Wai Ming; Yuen, Richard Kwok Kit

2017-02-01

This paper investigates the effect of the pedestrian density in building on the evacuation dynamic with simulation method. In the simulations, both the visibility in building and the exit limit of building are taken into account. The simulation results show that the effect of the pedestrian density in building on the evacuation dynamics is dual. On the one hand, when the visibility in building is very large, the increased pedestrian density plays a negative effect. On the other hand, when the visibility in building is very small, the increased pedestrian density can play a positive effect. The simulation results also show that when both the exit width and visibility are very small, the varying of evacuation time with regard to the pedestrian density is non-monotonous and presents a U-shaped tendency. That is, in this case, too large or too small pedestrian density in building is disadvantageous to the evacuation process. Our findings provide a new insight about the effect of the pedestrian density in building on the evacuation dynamic.

Household evacuation characteristics in American Samoa during the 2009 Samoa Islands tsunami.

PubMed

Apatu, Emma J I; Gregg, Chris E; Wood, Nathan J; Wang, Liang

2016-10-01

Tsunamis represent significant threats to human life and development in coastal communities. This quantitative study examines the influence of household characteristics on evacuation actions taken by 211 respondents in American Samoa who were at their homes during the 29 September 2009 Mw 8.1 Samoa Islands earthquake and tsunami disaster. Multiple logistic regression analysis of survey data was used to examine the association between evacuation and various household factors. Findings show that increases in distance to shoreline were associated with a slightly decreased likelihood of evacuation, whereas households reporting higher income had an increased probability of evacuation. The response in American Samoa was an effective one, with only 34 fatalities in a tsunami that reached shore in as little as 15 minutes. Consequently, future research should implement more qualitative study designs to identify event and cultural specific determinants of household evacuation behaviour to local tsunamis. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Pedestrian evacuation at the subway station under fire

NASA Astrophysics Data System (ADS)

Xiao-Xia, Yang; Hai-Rong, Dong; Xiu-Ming, Yao; Xu-Bin, Sun

2016-04-01

With the development of urban rail transit, ensuring the safe evacuation of pedestrians at subway stations has become an important issue in the case of an emergency such as a fire. This paper chooses the platform of line 4 at the Beijing Xuanwumen subway station to study the emergency evacuation process under fire. Based on the established platform, effects of the fire dynamics, different initial pedestrian densities, and positions of fire on evacuation are investigated. According to simulation results, it is found that the fire increases the air temperature and the smoke density, and decreases pedestrians’ visibility and walking velocity. Also, there is a critical initial density at the platform if achieving a safe evacuation within the required 6 minutes. Furthermore, different positions of fire set in this paper have little difference on crowd evacuation if the fire is not large enough. The suggestions provided in this paper are helpful for the subway operators to prevent major casualties. Project supported by the National Natural Science Foundation of China (Grant Nos. 61322307 and 61233001).

Operation Pied Piper: a geographical reappraisal of the impact of wartime evacuation on scarlet fever and diphtheria rates in England and Wales, 1939-1945.

PubMed

Smallman-Raynor, M R; Cliff, A D

2015-10-01

This paper examines the geographical impact of the British Government's wartime evacuation scheme on notified rates of two common acute childhood diseases (scarlet fever and diphtheria) in the 1470 local government districts of England and Wales, 1939-1945. Drawing on the notifications of communicable diseases collated by the General Register Office (GRO), we establish pre-war (baseline) disease rates for the 1470 districts. For the war years, techniques of binary logistic regression analysis are used to assess the associations between (a) above-baseline ('raised') disease rates in evacuation, neutral and reception districts and (b) the major phases of the evacuation scheme. The analysis demonstrates that the evacuation was temporally associated with distinct national and regional effects on notified levels of disease activity. These effects were most pronounced in the early years of the dispersal (1939-1941) and corresponded with initial levels of evacuation-related population change at the regional and district scales.

A fuzzy-theory-based behavioral model for studying pedestrian evacuation from a single-exit room

NASA Astrophysics Data System (ADS)

Fu, Libi; Song, Weiguo; Lo, Siuming

2016-08-01

Many mass events in recent years have highlighted the importance of research on pedestrian evacuation dynamics. A number of models have been developed to analyze crowd behavior under evacuation situations. However, few focus on pedestrians' decision-making with respect to uncertainty, vagueness and imprecision. In this paper, a discrete evacuation model defined on the cellular space is proposed according to the fuzzy theory which is able to describe imprecise and subjective information. Pedestrians' percept information and various characteristics are regarded as fuzzy input. Then fuzzy inference systems with rule bases, which resemble human reasoning, are established to obtain fuzzy output that decides pedestrians' movement direction. This model is tested in two scenarios, namely in a single-exit room with and without obstacles. Simulation results reproduce some classic dynamics phenomena discovered in real building evacuation situations, and are consistent with those in other models and experiments. It is hoped that this study will enrich movement rules and approaches in traditional cellular automaton models for evacuation dynamics.

Visitors’ awareness of the tsunami evacuation plan in Pasar Raya Padang, Indonesia

NASA Astrophysics Data System (ADS)

Kemal, B. M.; Yosritzal; Purnawan; Putra, H.

2018-04-01

This paper presents an investigation into the visitors’ awareness of the tsunami evacuation plan at Pasar Raya Padang, a traditional market at the central business district of Padang City, Indonesia. This study has been motivated by the fact that Pasar Raya Padang is the largest traditional market in West Sumatera and visited by many visitors from various origins. Pasar Raya Padang is chosen because it is located at a tsunami prone area, but local government managed to keep businesses in the area running and attract visitors. The awareness of the people in the market would be crucial to increase the possibility to safe their life during an evacuation. As much as 500 respondents were interviewed during daytime in the market. The study found that most of the visitors are not aware of the tsunami evacuation plan in the area. Local government is suggested to develop standard procedure for the evacuation, to place more sign and make it more visible for most of the visitors and do evacuation simulations periodically.

Development of a decision support system for tsunami evacuation: application to the Jiyang District of Sanya city in China

NASA Astrophysics Data System (ADS)

Hou, Jingming; Yuan, Ye; Wang, Peitao; Ren, Zhiyuan; Li, Xiaojuan

2017-03-01

Major tsunami disasters often cause great damage in the first few hours following an earthquake. The possible severity of such events requires preparations to prevent tsunami disasters or mitigate them. This paper is an attempt to develop a decision support system for rapid tsunami evacuation for local decision makers. Based on the numerical results database of tsunami disasters, this system can quickly obtain the tsunami inundation and travel time. Because numerical models are calculated in advance, this system can reduce decision-making time. Population distribution, as a vulnerability factor, was analyzed to identify areas of high risk for tsunami disasters. Combined with spatial data, this system can comprehensively analyze the dynamic and static evacuation process and identify problems that negatively impact evacuation, thus supporting the decision-making for tsunami evacuation in high-risk areas. When an earthquake and tsunami occur, this system can rapidly obtain the tsunami inundation and travel time and provide information to assist with tsunami evacuation operations.

Analysis of sheltering and evacuation strategies for an urban nuclear detonation scenario.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoshimura, Ann S.; Brandt, Larry D.

2009-05-01

Development of an effective strategy for shelter and evacuation is among the most important planning tasks in preparation for response to a low yield, nuclear detonation in an urban area. This study examines shelter-evacuate policies and effectiveness focusing on a 10 kt scenario in Los Angeles. The goal is to provide technical insights that can support development of urban response plans. Results indicate that extended shelter-in-place can offer the most robust protection when high quality shelter exists. Where less effective shelter is available and the fallout radiation intensity level is high, informed evacuation at the appropriate time can substantially reducemore » the overall dose to personnel. However, uncertainties in the characteristics of the fallout region and in the exit route can make evacuation a risky strategy. Analyses indicate that only a relatively small fraction of the total urban population may experience significant dose reduction benefits from even a well-informed evacuation plan.« less

Application of Catastrophe Risk Modelling to Evacuation Public Policy

NASA Astrophysics Data System (ADS)

Woo, G.

2009-04-01

The decision by civic authorities to evacuate an area threatened by a natural hazard is especially fraught when the population in harm's way is extremely large, and where there is considerable uncertainty in the spatial footprint, scale, and strike time of a hazard event. Traditionally viewed as a hazard forecasting issue, civil authorities turn to scientists for advice on a potentially imminent dangerous event. However, the level of scientific confidence varies enormously from one peril and crisis situation to another. With superior observational data, meteorological and hydrological hazards are generally better forecast than geological hazards. But even with Atlantic hurricanes, the track and intensity of a hurricane can change significantly within a few hours. This complicated and delayed the decision to call an evacuation of New Orleans when threatened by Hurricane Katrina, and would present a severe dilemma if a major hurricane were appearing to head for New York. Evacuation needs to be perceived as a risk issue, requiring the expertise of catastrophe risk modellers as well as geoscientists. Faced with evidence of a great earthquake in the Indian Ocean in December 2004, seismologists were reluctant to give a tsunami warning without more direct sea observations. Yet, from a risk perspective, the risk to coastal populations would have warranted attempts at tsunami warning, even though there was significant uncertainty in the hazard forecast, and chance of a false alarm. A systematic coherent risk-based framework for evacuation decision-making exists, which weighs the advantages of an evacuation call against the disadvantages. Implicitly and qualitatively, such a cost-benefit analysis is undertaken by civic authorities whenever an evacuation is considered. With the progress in catastrophe risk modelling, such an analysis can be made explicit and quantitative, providing a transparent audit trail for the decision process. A stochastic event set, the core of a catastrophe risk model, is required to explore the casualty implications of different possible hazard scenarios, to assess the proportion of an evacuated population who would owe their lives to an evacuation, and to estimate the economic loss associated with an unnecessary evacuation. This paper will review the developing methodology for applying catastrophe risk modelling to support public policy in evacuation decision-making, and provide illustrations from across the range of natural hazards. Evacuation during volcanic crises is a prime example, recognizing the improving forecasting skill of volcanologists, now able to account probabilistically for precursory seismological, geodetic, and geochemical monitoring data. This methodology will be shown to help civic authorities make sounder risk-informed decisions on the timing and population segmentation of evacuation from both volcanoes and calderas, such as Vesuvius and Campi Flegrei, which are in densely populated urban regions.

Leveraging Twitter to gauge evacuation compliance: Spatiotemporal analysis of Hurricane Matthew

PubMed Central

Martín, Yago; Cutter, Susan L.

2017-01-01

Hurricane Matthew was the deadliest Atlantic storm since Katrina in 2005 and prompted one of the largest recent hurricane evacuations along the Southeastern coast of the United States. The storm and its projected landfall triggered a massive social media reaction. Using Twitter data, this paper examines the spatiotemporal variability in social media response and develops a novel approach to leverage geotagged tweets to assess the evacuation responses of residents. The approach involves the retrieval of tweets from the Twitter Stream, the creation and filtering of different datasets, and the statistical and spatial processing and treatment to extract, plot and map the results. As expected, peak Twitter response was reached during the pre-impact and preparedness phase, and decreased abruptly after the passage of the storm. A comparison between two time periods—pre-evacuation (October 2th-4th) and post-evacuation (October 7th-9th)—indicates that 54% of Twitter users moved away from the coast to a safer location, with observed differences by state on the timing of the evacuation. A specific sub-state analysis of South Carolina illustrated overall compliance with evacuation orders and detailed information on the timing of departure from the coast as well as the destination location. These findings advance the use of big data and citizen-as-sensor approaches for public safety issues, providing an effective and near real-time alternative for measuring compliance with evacuation orders. PMID:28753667

The impact of a major earthquake on the evacuation of the emergency planning zone of a nuclear power plant.

PubMed

Cohen, Rebecca; Weinisch, Kevin

2015-01-01

United States regulations require nuclear power plants (NPPs) to estimate the time needed to evacuate the emergency planning zone (EPZ, a circle with an approximate 10-mile radius centered at the NPP). These evacuation time estimate (ETE) studies are to be used by emergency personnel in the event of a radiological emergency. ETE studies are typically done using traffic simulation and evacuation models, based on traffic engineering algorithms that reflect congestion and delay. ETE studies are typically conducted assuming all evacuation routes are traversable. As witnessed in the Great East Japan Earthquake in March 2011, an earthquake and the ensuing tsunami can cause an incident at a NPP that requires an evacuation of the public. The earthquake and tsunami can also damage many of the available bridges and roadways and, therefore, impede evacuation and put people at risk of radiation exposure. This article presents a procedure, using traffic simulation and evacuation models, to estimate the impact on ETE due to bridge and roadway damage caused by a major earthquake, or similar hazardous event. The results of this analysis are used by emergency personnel to make protective action decisions that will minimize the exposure of radiation to the public. Additionally, the results allow emergency planners to ensure proper equipment and personnel are available for these types of events. Emergency plans are revised to ensure prompt response and recovery action during critical times.

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Marine evacuation system launching arrangements. 108.545 Section 108.545 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.545 Marine evacuation system launching...

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Marine evacuation system launching arrangements. 108.545 Section 108.545 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.545 Marine evacuation system launching...

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Marine evacuation system launching arrangements. 108.545 Section 108.545 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.545 Marine evacuation system launching...

Modeling hurricane evacuation traffic : development of a time-dependent hurricane evacuation demand model.

DOT National Transportation Integrated Search

2008-04-01

The objective of this research is to develop alternative time-dependent travel demand models of hurricane evacuation travel and to compare the performance of these models with each other and with the state-of-the-practice models in current use. Speci...

An Evidence-Based Public Health Approach to Injury Priorities and Prevention. Recommendations for the U.S. Military

DTIC Science & Technology

2010-01-01

account for about 35% of such medical evacu- tions, compared to 16% for battle injuries and 7% for igestive diseases, the leading non -injury reason for...organization such as the military to successfully pre- ent injuries, it is necessary for each of the fıve functional lements to be operating. Although the...fırst applied the evidence-based able 1. Functional steps of the public health approach t Functional step of prevention process Description of function 1

33 CFR 150.506 - When must the operator service inflatable lifesaving appliances and marine evacuation systems?

Code of Federal Regulations, 2010 CFR

2010-07-01

... inflatable lifesaving appliances and marine evacuation systems? 150.506 Section 150.506 Navigation and...: OPERATIONS Emergency and Specialty Equipment Inflatable Lifesaving Appliances § 150.506 When must the operator service inflatable lifesaving appliances and marine evacuation systems? (a) The operator must...

21 CFR 882.5850 - Implanted spinal cord stimulator for bladder evacuation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Implanted spinal cord stimulator for bladder evacuation. 882.5850 Section 882.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....5850 Implanted spinal cord stimulator for bladder evacuation. (a) Identification. An implanted spinal...

21 CFR 882.5850 - Implanted spinal cord stimulator for bladder evacuation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted spinal cord stimulator for bladder evacuation. 882.5850 Section 882.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....5850 Implanted spinal cord stimulator for bladder evacuation. (a) Identification. An implanted spinal...

28 CFR 0.154 - Advance and evacuation payments and special allowances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Advance and evacuation payments and... Advance and evacuation payments and special allowances. The Director of the Federal Bureau of... Marshals Service, and the Director of the Office of Justice Assistance, Research and Statistics, as to...

75 FR 79034 - Proposed Extension of Existing Information Collection; Escape and Evacuation Plans (Pertains to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... Extension of Existing Information Collection; Escape and Evacuation Plans (Pertains to Underground Metal and... and evacuation plan specifically addressing the unique conditions of each underground metal and... fans, primary fan controls, fire doors, ventilation doors, and refuge chambers; (2) Procedures to show...

Game-Based Evacuation Drill Using Augmented Reality and Head-Mounted Display

ERIC Educational Resources Information Center

Kawai, Junya; Mitsuhara, Hiroyuki; Shishibori, Masami

2016-01-01

Purpose: Evacuation drills should be more realistic and interactive. Focusing on situational and audio-visual realities and scenario-based interactivity, the authors have developed a game-based evacuation drill (GBED) system that presents augmented reality (AR) materials on tablet computers. The paper's current research purpose is to improve…

14 CFR 125.189 - Demonstration of emergency evacuation procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the emergency evacuation procedures for each type and model of airplane with a seating of more than 44... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Demonstration of emergency evacuation procedures. 125.189 Section 125.189 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

30 CFR 77.1101 - Escape and evacuation; plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Fire Protection § 77.1101 Escape and evacuation; plan. (a) Before September 30, 1971, each operator of... event of a fire. (b) All employees shall be instructed on current escape and evacuation plans, fire alarm signals, and applicable procedures to be followed in case of fire. (c) Plans for escape and...

30 CFR 77.1101 - Escape and evacuation; plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Fire Protection § 77.1101 Escape and evacuation; plan. (a) Before September 30, 1971, each operator of... event of a fire. (b) All employees shall be instructed on current escape and evacuation plans, fire alarm signals, and applicable procedures to be followed in case of fire. (c) Plans for escape and...

30 CFR 57.4363 - Underground evacuation instruction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and evacuation plans and procedures and fire warning signals in effect at the mine. (b) Whenever a change is made in escape and evacuation plans and procedures for any area of the mine, all persons... NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Fire...

30 CFR 77.1101 - Escape and evacuation; plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Fire Protection § 77.1101 Escape and evacuation; plan. (a) Before September 30, 1971, each operator of... event of a fire. (b) All employees shall be instructed on current escape and evacuation plans, fire alarm signals, and applicable procedures to be followed in case of fire. (c) Plans for escape and...

30 CFR 57.4363 - Underground evacuation instruction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and evacuation plans and procedures and fire warning signals in effect at the mine. (b) Whenever a change is made in escape and evacuation plans and procedures for any area of the mine, all persons... NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Fire...

30 CFR 57.4363 - Underground evacuation instruction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and evacuation plans and procedures and fire warning signals in effect at the mine. (b) Whenever a change is made in escape and evacuation plans and procedures for any area of the mine, all persons... NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Fire...

30 CFR 77.1101 - Escape and evacuation; plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Fire Protection § 77.1101 Escape and evacuation; plan. (a) Before September 30, 1971, each operator of... event of a fire. (b) All employees shall be instructed on current escape and evacuation plans, fire alarm signals, and applicable procedures to be followed in case of fire. (c) Plans for escape and...

Empirical study on social groups in pedestrian evacuation dynamics

NASA Astrophysics Data System (ADS)

von Krüchten, Cornelia; Schadschneider, Andreas

2017-06-01

Pedestrian crowds often include social groups, i.e. pedestrians that walk together because of social relationships. They show characteristic configurations and influence the dynamics of the entire crowd. In order to investigate the impact of social groups on evacuations we performed an empirical study with pupils. Several evacuation runs with groups of different sizes and different interactions were performed. New group parameters are introduced which allow to describe the dynamics of the groups and the configuration of the group members quantitatively. The analysis shows a possible decrease of evacuation times for large groups due to self-ordering effects. Social groups can be approximated as ellipses that orientate along their direction of motion. Furthermore, explicitly cooperative behaviour among group members leads to a stronger aggregation of group members and an intermittent way of evacuation.

Transperineal ultrasound compared to evacuation proctography for diagnosing enteroceles and intussusceptions.

PubMed

Weemhoff, M; Kluivers, K B; Govaert, B; Evers, J L H; Kessels, A G H; Baeten, C G

2013-03-01

This study concerns the level of agreement between transperineal ultrasound and evacuation proctography for diagnosing enteroceles and intussusceptions. In a prospective observational study, 50 consecutive women who were planned to have an evacuation proctography underwent transperineal ultrasound too. Sensitivity, specificity, positive (PPV) and negative predictive value, as well as the positive and negative likelihood ratio of transperineal ultrasound were assessed in comparison to evacuation proctography. To determine the interobserver agreement of transperineal ultrasound, the quadratic weighted kappa was calculated. Furthermore, receiver operating characteristic curves were generated to show the diagnostic capability of transperineal ultrasound. For diagnosing intussusceptions (PPV 1.00), a positive finding on transperineal ultrasound was predictive of an abnormal evacuation proctography. Sensitivity of transperineal ultrasound was poor for intussusceptions (0.25). For diagnosing enteroceles, the positive likelihood ratio was 2.10 and the negative likelihood ratio, 0.85. There are many false-positive findings of enteroceles on ultrasonography (PPV 0.29). The interobserver agreement of the two ultrasonographers assessed as the quadratic weighted kappa of diagnosing enteroceles was 0.44 and that of diagnosing intussusceptions was 0.23. An intussusception on ultrasound is predictive of an abnormal evacuation proctography. For diagnosing enteroceles, the diagnostic quality of transperineal ultrasound was limited compared to evacuation proctography.

Barium proctography vs magnetic resonance proctography for pelvic floor disorders: a comparative study.

PubMed

Pilkington, S A; Nugent, K P; Brenner, J; Harris, S; Clarke, A; Lamparelli, M; Thomas, C; Tarver, D

2012-10-01

Accurate and reliable imaging of pelvic floor dynamics is important for tailoring treatment in pelvic floor disorders; however, two imaging modalities are available. Barium proctography (BaP) is widely used, but involves a significant radiation dose. Magnetic resonance (MR) proctography allows visualization of all pelvic midline structures but patients are supine. This project investigates whether there are measurable differences between BaP and MR proctography. Patient preference for the tests was also investigated. Consecutive patients referred for BaP were invited to participate (National Research Ethics Service approved). Participants underwent BaP in Poole and MR proctography in Dorchester. Proctograms were reported by a consultant radiologist with pelvic floor subspecialization. A total of 71 patients were recruited. Both tests were carried out on 42 patients. Complete rectal emptying was observed in 29% (12/42) on BaP and in 2% (1/42) on MR proctography. Anismus was reported in 29% (12/42) on BaP and 43% (18/42) on MR proctography. MR proctography missed 31% (11/35) of rectal intussusception detected on BaP. In 10 of these cases no rectal evacuation was achieved during MR proctography. The measure of agreement between grade of rectal intussusception was fair (κ=0.260) although MR proctography tended to underestimate the grade. Rectoceles were extremely common but clinically relevant differences in size were evident. Patients reported that they found MR proctography less embarrassing but harder to empty their bowel. The results demonstrate that MR proctography under-reports pelvic floor abnormalities especially where there has been poor rectal evacuation. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

Army Medical Department Officers in Division Assignments: Prepared to Succeed, or Doomed to Fail?

DTIC Science & Technology

1992-04-15

officers for tactical unit asgnments. IL.BACKGROUND In the late 1970s, the concept of multi-functional. forward support battalions (FSB) i divisions...functions. Headquarters made up of officers who were each experienced in a single discipline replaced these centers of expertise. The concept assumed that...the evacuation of casualties and movement of the medical unit. Although many of these capabilities exists in the FSB concept , flexibility and

Endoscopic Evacuation of Basal Ganglia Hematoma: Surgical Technique, Outcome, and Learning Curve.

PubMed

Ma, Lichao; Hou, Yuanzheng; Zhu, Ruyuan; Chen, Xiaolei

2017-05-01

Minimally invasive endoscopic hematoma evacuation is a promising treatment option for intracerebral hemorrhage. However, the technique still needs improvement. We report our clinical experience of using this technique to evacuate deep-seated basal ganglia hematomas. The frontal approach was used in most patients. The preoperative and postoperative hematoma volumes, Glasgow Coma Scale, hematoma evacuation rate, 30-day mortality, and long-term outcome defined by the modified Rankin Scale were analyzed retrospectively. The surgical duration per milliliter of clot (DPM) was calculated. The learning curve for this technique was determined based on the relation between the DPM and evacuation rate per the number of cases experienced. A total of 24 patients were enrolled. The evacuation rate was 87% ± 10%. The average Glasgow Coma Scale score recovered from 8 to 13 after surgery. Twenty-one patients had follow-up data. The follow-up time was 13 ± 6 months. The 30-day mortality after surgery was zero. Forty-eight percent of patients (10/21) achieved a favorable outcome. The DPM (P = 0.92) and evacuation rate (P = 0.64) did not change substantially with the number of cases experienced. Endoscopic port surgery for hematoma evacuation via the frontal approach is a safe surgical option for deep-seated basal ganglia hematomas. This technique is minimally invasive and may be helpful to provide better long-term outcomes for selected patients. For neurosurgeons, the learning curve for this technique is steep, which implies that the skills needed for our technique can be easily acquired. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of varying two key parameters in simulating evacuation for a dormitory in China

NASA Astrophysics Data System (ADS)

Lei, Wenjun; Li, Angui; Gao, Ran

2013-01-01

Student dormitories are both living and resting areas for students in their spare time. There are many small rooms in the dormitories. And the students are distributed densely in the dormitories. High occupant density is the main characteristic of student dormitories. Once there is an accident, such as fire or earthquake, the losses will be cruel. Computer evacuation models developed overseas are commonly applied in working out safety management schemes. The average minimum widths of corridor and exit are the two key parameters affecting the evacuation for the dormitory. The effect of varying these two parameters will be studied in this paper by taking a dormitory in our university as an example. Evacuation performance is predicted with the software FDS + Evac. The default values in the software are used and adjusted through a field survey. The effect of varying either of the two parameters is discussed. It is found that the simulated results agree well with the experimental results. From our study it seems that the evacuation time is not in proportion to the evacuation distance. And we also named a phenomenon of “the closer is not the faster”. For the building researched in this article, a corridor width of 3 m is the most appropriate. And the suitable exit width of the dormitory for evacuation is about 2.5 to 3 m. The number of people has great influence on the walking speed of people. The purpose of this study is to optimize the building, and to make the building in favor of personnel evacuation. Then the damage could be minimized.

Influence of road network and population demand assumptions in evacuation modeling for distant tsunamis

USGS Publications Warehouse

Henry, Kevin; Wood, Nathan J.; Frazier, Tim G.

2017-01-01

Tsunami evacuation planning in coastal communities is typically focused on local events where at-risk individuals must move on foot in a matter of minutes to safety. Less attention has been placed on distant tsunamis, where evacuations unfold over several hours, are often dominated by vehicle use and are managed by public safety officials. Traditional traffic simulation models focus on estimating clearance times but often overlook the influence of varying population demand, alternative modes, background traffic, shadow evacuation, and traffic management alternatives. These factors are especially important for island communities with limited egress options to safety. We use the coastal community of Balboa Island, California (USA), as a case study to explore the range of potential clearance times prior to wave arrival for a distant tsunami scenario. We use a first-in–first-out queuing simulation environment to estimate variations in clearance times, given varying assumptions of the evacuating population (demand) and the road network over which they evacuate (supply). Results suggest clearance times are less than wave arrival times for a distant tsunami, except when we assume maximum vehicle usage for residents, employees, and tourists for a weekend scenario. A two-lane bridge to the mainland was the primary traffic bottleneck, thereby minimizing the effect of departure times, shadow evacuations, background traffic, boat-based evacuations, and traffic light timing on overall community clearance time. Reducing vehicular demand generally reduced clearance time, whereas improvements to road capacity had mixed results. Finally, failure to recognize non-residential employee and tourist populations in the vehicle demand substantially underestimated clearance time.

Literature Search for Federal Highway Administration (ITS-JPO) : assessment of state of the practice and state of the art in evacuation transportation management

DOT National Transportation Integrated Search

2006-02-06

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

33 CFR 165.1413 - Regulated navigation area; Southern Oahu Tsunami Evacuation; Honolulu, Hawaii.

Code of Federal Regulations, 2014 CFR

2014-07-01

...; Southern Oahu Tsunami Evacuation; Honolulu, Hawaii. 165.1413 Section 165.1413 Navigation and Navigable... Fourteenth Coast Guard District § 165.1413 Regulated navigation area; Southern Oahu Tsunami Evacuation... staging area is intended for use by all commercial vessels intended to remain in the RNA during a tsunami...

Distance Learning Methodologies. TRANSCOM Regulating and Command & Control Evacuation System (TRAC2ES).

ERIC Educational Resources Information Center

Bloomquist, Carroll R.

The TRANSCOM (Transportation Command) Regulating Command and Control Evacuation System (TRAC2ES), which applies state-of-the-art technology to manage global medical regulating (matching patients to clinical availability) and medical evacuation processes, will be installed at all Department of Defense medical locations globally. A combination of…

Modeling hurricane evacuation traffic : testing the gravity and intervening opportunity models as models of destination choice in hurricane evacuation.

DOT National Transportation Integrated Search

2006-09-01

The test was conducted by estimating the models on a portion of evacuation data from South Carolina following Hurricane Floyd, and then observing how well the models reproduced destination choice at the county level on the remaining data. The tests s...

ALFIL: A Crowd Simulation Serious Game for Massive Evacuation Training and Awareness

ERIC Educational Resources Information Center

García-García, César; Fernández-Robles, José Luis; Larios-Rosillo, Victor; Luga, Hervé

2012-01-01

This article presents the current development of a serious game for the simulation of massive evacuations. The purpose of this project is to promote self-protection through awareness of the procedures and different possible scenarios during the evacuation of a massive event. Sophisticated behaviors require massive computational power and it has…

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

Clarifying evacuation options through fire behavior and traffic modeling

Treesearch

Carol L. Rice; Ronny J. Coleman; Mike Price

2011-01-01

Communities are becoming increasingly concerned with the variety of choices related to wildfire evacuation. We used ArcView with Network Analyst to evaluate the different options for evacuations during wildfire in a case study community. We tested overlaying fire growth patterns with the road network and population characteristics to determine recommendations for...

38 CFR 17.58 - Evacuation of community nursing homes.

Code of Federal Regulations, 2014 CFR

2014-07-01

... nursing homes. 17.58 Section 17.58 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.58 Evacuation of community nursing homes. When veterans are evacuated from a community nursing home as the result of an emergency, they may be relocated...

38 CFR 17.58 - Evacuation of community nursing homes.

Code of Federal Regulations, 2013 CFR

2013-07-01

... nursing homes. 17.58 Section 17.58 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.58 Evacuation of community nursing homes. When veterans are evacuated from a community nursing home as the result of an emergency, they may be relocated...

38 CFR 17.58 - Evacuation of community nursing homes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... nursing homes. 17.58 Section 17.58 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.58 Evacuation of community nursing homes. When veterans are evacuated from a community nursing home as the result of an emergency, they may be relocated...

Improving an inherently stressful situation: the role of communication during wildfire evacuations

Treesearch

Melanie Stidham; Eric Toman; Sarah M. McCaffrey; Bruce Schinder

2011-01-01

Wildfire evacuations are inherently stressful and homeowners have reported in previous studies that uncertainty over what is happening is perhaps one of the most stressful aspects. Although many difficult elements of evacuation cannot be mitigated and lives will certainly be disrupted, fire-management agencies can significantly reduce residents' uncertainty with...

Post-tsunami outbreaks of influenza in evacuation centers in Miyagi Prefecture, Japan.

PubMed

Hatta, Masumitsu; Endo, Shiro; Tokuda, Koichi; Kunishima, Hiroyuki; Arai, Kazuaki; Yano, Hisakazu; Ishibashi, Noriomi; Aoyagi, Tetsuji; Yamada, Mitsuhiro; Inomata, Shinya; Kanamori, Hajime; Gu, Yoshiaki; Kitagawa, Miho; Hirakata, Yoichi; Kaku, Mitsuo

2012-01-01

We describe 2 post-tsunami outbreaks of influenza A in evacuation centers in Miyagi Prefecture, Japan, in 2011. Although containment of the outbreak was challenging in the evacuation settings, prompt implementation of a systemic approach with a bundle of control measures was important to control the influenza outbreaks.

A fuzzy Bayesian network approach to quantify the human behaviour during an evacuation

NASA Astrophysics Data System (ADS)

Ramli, Nurulhuda; Ghani, Noraida Abdul; Ahmad, Nazihah

2016-06-01

Bayesian Network (BN) has been regarded as a successful representation of inter-relationship of factors affecting human behavior during an emergency. This paper is an extension of earlier work of quantifying the variables involved in the BN model of human behavior during an evacuation using a well-known direct probability elicitation technique. To overcome judgment bias and reduce the expert's burden in providing precise probability values, a new approach for the elicitation technique is required. This study proposes a new fuzzy BN approach for quantifying human behavior during an evacuation. Three major phases of methodology are involved, namely 1) development of qualitative model representing human factors during an evacuation, 2) quantification of BN model using fuzzy probability and 3) inferencing and interpreting the BN result. A case study of three inter-dependencies of human evacuation factors such as danger assessment ability, information about the threat and stressful conditions are used to illustrate the application of the proposed method. This approach will serve as an alternative to the conventional probability elicitation technique in understanding the human behavior during an evacuation.

Stoma management in a tropical country: colostomy irrigation versus natural evacuation.

PubMed

Leong, A F; Yunos, A B

1999-11-01

People with ostomies in Singapore were initially resistant to colostomy irrigation. This study, a prospective crossover study of 26 patients who underwent abdominoperineal resection, compared colostomy irrigation with the natural evacuation method. During the colostomy-irrigation phase of the study, all 26 patients reported an improvement in continence and fewer problems with sleep, sex, and skin complications compared to the natural-evacuation phase. The study also found a reduction in monthly expenses with colostomy irrigation compared to natural evacuation. Patient satisfaction scores were also superior during the colostomy-irrigation phase. This difference in satisfaction scores was less marked in those who were more than 1-year postsurgery than in those who were less than 1-year postsurgery. The difference in satisfaction between colostomy irrigation and natural evacuation scores was statistically significant in the group that was less than 1-year postsurgery, but not in the group that was more than 1-year postsurgery. The study concluded that colostomy irrigation after abdominoperineal resection is superior to natural evacuation in terms of cost and patient satisfaction and should be introduced soon after surgery.

Civilians under fire: evacuation behaviour in north Israel during the Second Lebanon War.

PubMed

Gidron, David; Peleg, Kobi; Jaffe, Dena; Shenhar, Gili

2010-10-01

This paper seeks to understand evacuation behaviour in a case of spontaneous evacuation. During the Second Lebanon War of 2006, more than one-third of residents in north Israel spontaneously evacuated--the remainder stayed in situ. Using a telephone survey of 665 respondents residing in north Israel, we were able to characterise the behaviour of evacuees and non-evacuees. The main reasons cited for evacuating were fear of injury to self or family, the effect on children, inability to remain in a protective space, and family pressure. The main reasons cited for remaining at home were no suitable alternative, did not perceive a high level of danger, had to go to work, and there is no place like home. There were no significant differences with regard to most socio-demographic characteristics of the population. These findings should aid emergency managers in preparing the population for a future emergency and in engaging in effective dialogue with the population during an emergency on the evacuation option. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

Improving Access to Pediatric Cardiology in Cape Verde via a Collaborative International Telemedicine Service.

PubMed

Lapão, Luís Velez; Correia, Artur

2015-01-01

This paper addresses the role of international telemedicine services in supporting the evacuation procedures from Cape Verde to Portugal, enabling better quality and cost reductions in the management of the global health system. The Cape Verde, as other African countries, health system lacks many medical specialists, like pediatric cardiologists, neurosurgery, etc. In this study, tele-cardiology shows good results as diagnostic support to the evacuation decision. Telemedicine services show benefits while monitoring patients in post-evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with tele-cardiology collaborative service many evacuations can be avoided whereas many cases will be treated and followed locally in Cape Verde with remote technical support from Portugal. This international telemedicine service enabled more efficient evacuations, by reducing expenses in travel and housing, and therefore contributed to the health system's improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians.

Lessons learned from the total evacuation of a hospital after the 2016 Kumamoto Earthquake.

PubMed

Yanagawa, Youichi; Kondo, Hisayoshi; Okawa, Takashi; Ochi, Fumio

The 2016 Kumamoto Earthquakes were a series of earthquakes that included a foreshock earthquake (magnitude 6.2) on April 14 and a main shock (magnitude 7.0) on April 16, 2016. A number of hospitals in Kumamoto were severely damaged by the two major earthquakes and required total evacuation. The authors retrospectively analyzed the activity data of the Disaster Medical Assistance Teams using the Emergency Medical Information System records to investigate the cases in which the total evacuation of a hospital was attempted following the 2016 Kumamoto Earthquake. Total evacuation was attempted at 17 hospitals. The evacuation of one of these hospitals was canceled. Most of the hospital buildings were more than 20 years old. The danger of collapse was the most frequent reason for evacuation. Various transportation methods were employed, some of which involved the Japan Ground Self-Defense Force; no preventable deaths occurred during transportation. The hospitals must now be renovated to improve their earthquake resistance. The coordinated and combined use of military and civilian resources is beneficial and can significantly reduce human suffering in large-scale disasters.

Unaccompanied evacuation and adult mortality: evaluating the finnish policy of evacuating children to foster care during World War II.

PubMed

Santavirta, Torsten

2014-09-01

I examined associations between evacuation of Finnish children to temporary foster care in Sweden during World War II and all-cause mortality between ages 38 and 78 years. I used a Cox proportional hazards model to estimate mortality risk according to whether the individual was evacuated during childhood or not. I used within-sibling analysis to control for all unobserved socioeconomic and genetic characteristics shared among siblings. Individual-level data for Finnish cohorts born in 1933 to 1944 were derived from wartime government records, Finnish census data from 1950 and 1970, and death cause registry from 1971 to 2011. I found no statistically significant association between evacuation and all-cause mortality when all exposed individuals were included in the analysis. However, subgroup analysis showed that men evacuated before age 4 years had a 1.31 higher mortality risk (95% confidence interval = 1.01, 1.69) than their nonevacuated counterparts. In the aggregate, individuals do not have elevated mortality risk as a consequence of foster care during early childhood owing to the onset of sudden external shocks (e.g., wars).

A Simple Evacuation Modeling and Simulation Tool for First Responders

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koch, Daniel B; Payne, Patricia W

2015-01-01

Although modeling and simulation of mass evacuations during a natural or man-made disaster is an on-going and vigorous area of study, tool adoption by front-line first responders is uneven. Some of the factors that account for this situation include cost and complexity of the software. For several years, Oak Ridge National Laboratory has been actively developing the free Incident Management Preparedness and Coordination Toolkit (IMPACT) to address these issues. One of the components of IMPACT is a multi-agent simulation module for area-based and path-based evacuations. The user interface is designed so that anyone familiar with typical computer drawing tools canmore » quickly author a geospatially-correct evacuation visualization suitable for table-top exercises. Since IMPACT is designed for use in the field where network communications may not be available, quick on-site evacuation alternatives can be evaluated to keep pace with a fluid threat situation. Realism is enhanced by incorporating collision avoidance into the simulation. Statistics are gathered as the simulation unfolds, including most importantly time-to-evacuate, to help first responders choose the best course of action.« less

Integrated function nonimaging concentrating collector tubes for solar thermal energy

NASA Astrophysics Data System (ADS)

Winston, R.; Ogallagher, J. J.

1981-08-01

A substantial improvement in optical efficiency over contemporary external reflector evacuated tube collectors was achieved by integrating the reflector surface into the outer glass envelope. The design, fabrication and preliminary test results are described for a prototype collector based on this concept. Efficiencies above 40% up to nearly 300 C may be achieved.

Modified social force model based on information transmission toward crowd evacuation simulation

NASA Astrophysics Data System (ADS)

Han, Yanbin; Liu, Hong

2017-03-01

In this paper, the information transmission mechanism is introduced into the social force model to simulate pedestrian behavior in an emergency, especially when most pedestrians are unfamiliar with the evacuation environment. This modified model includes a collision avoidance strategy and an information transmission model that considers information loss. The former is used to avoid collision among pedestrians in a simulation, whereas the latter mainly describes how pedestrians obtain and choose directions appropriate to them. Simulation results show that pedestrians can obtain the correct moving direction through information transmission mechanism and that the modified model can simulate actual pedestrian behavior during an emergency evacuation. Moreover, we have drawn four conclusions to improve evacuation based on the simulation results; and these conclusions greatly contribute in optimizing a number of efficient emergency evacuation schemes for large public places.

Analysis of community tsunami evacuation time: An overview

NASA Astrophysics Data System (ADS)

Yunarto, Y.; Sari, A. M.

2018-02-01

Tsunami in Indonesia is defined as local tsunami due to its occurrences which are within a distance of 200 km from the epicenter of the earthquake. A local tsunami can be caused by an earthquake, landslide, or volcanic eruption. Tsunami arrival time in Indonesia is generally between 10-60 minutes. As the estimated time of the tsunami waves to reach the coast is 30 minutes after the earthquake, the community should go to the vertical or horizontal evacuation in less than 30 minutes. In an evacuation, the city frequently does the evacuation after obtaining official directions from the authorities. Otherwise, they perform an independent evacuation without correct instructions from the authorities. Both of these ways have several strengths and limitations. This study analyzes these methods regarding time as well as the number of people expected to be saved.

Evacuation dynamics with smoking diffusion in three dimension based on an extended Floor-Field model

NASA Astrophysics Data System (ADS)

Zheng, Ying; Li, Xingang; Zhu, Nuo; Jia, Bin; Jiang, Rui

2018-10-01

This paper proposes an extended Floor-Field (FF) model to study the pedestrian evacuation dynamics under the influence of smoke diffusing in three-dimension (3D). In addition to static and dynamic fields, the extended model adopts the smoke and herding fields to reflect pedestrian's smoke-avoiding behavior and herding behavior. The impact of smoke on pedestrians' health is also considered. The smoke will reduce the pedestrians' health point and finally impact their moving ability. Numerical simulations were carried out to study the evacuation dynamics. The influence of the smoke particles producing rate, the initial health point, the critical smoke concentration value, and the herding field on evacuation dynamics were analyzed in detail. Those results could bring some guidance to make the evacuation strategy in the smoke diffusing environment.

High pressures in room evacuation processes and a first approach to the dynamics around unconscious pedestrians

NASA Astrophysics Data System (ADS)

Cornes, F. E.; Frank, G. A.; Dorso, C. O.

2017-10-01

Clogging raises as the principal phenomenon during many evacuation processes of pedestrians in an emergency situation. As people push to escape from danger, compression forces may increase to harming levels. Many individuals might fall down, while others will try to dodge the fallen people, or, simply pass through them. We studied the dynamics of the crowd for these situations, in the context of the "social force model". We modeled the unconscious (fallen) pedestrians as inanimate bodies that can be dodged (or not) by the surrounding individuals. We found that new morphological structures appear along the evacuating crowd. Under specific conditions, these structures may enhance the evacuation performance. The pedestrian's willings for either dodging or passing through the unconscious individuals play a relevant role in the overall evacuation performance.

[Evacuation plan of an intensive care unit: a new quality indicator?].

PubMed

Sánchez-Palacios, M; Lorenzo Torrent, R; Santana-Cabrera, L; Martín García, J A; Campos, S G; Carrasco de Miguel, V

2010-04-01

The intensive care units must be prepared for a possible disaster, whether internal or external, in case it becomes necessary to evacuate the in-patients. They must have an Emergency and Self-protection Plan that includes the patient evacuation criteria and this must be known by all the personnel who work in the service. For that reason, the patients must be triaged, based on their attention priorities, according to their survival possibilities. Having an evacuation, known by all the personnel and updated by means of the performance of periodic drills, should be included as a quality indicator that must be met, since this would achieve better attention to the patient in case of a disaster situation requiring the evacuation of the ICU. Copyright 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

Outcomes after endoscopic port surgery for spontaneous intracerebral hematomas.

PubMed

Ochalski, Pawel; Chivukula, Srinivas; Shin, Samuel; Prevedello, Daniel; Engh, Johnathan

2014-05-01

Spontaneous intracerebral hemorrhages (ICHs) cause significant morbidity and mortality. Traditional open surgical management strategies offer limited benefit except for the most superficial hemorrhages in select patients. Recent reports suggest that endoscopic approaches may improve outcomes, particularly for deep subcortical hemorrhages. However, the management of these patients remains controversial. We reviewed our experience using endoscopic port surgery to identify characteristics that may predict acceptable outcomes. We completed a retrospective chart and imaging review of patients who underwent endoscopic port surgery for evacuation of spontaneous ICH at a single center. Data were gathered regarding patient demographics, hemorrhage locations, operative findings, and clinical outcomes. From 2007 to 2011, 18 patients underwent evacuation of spontaneous intracerebral hematomas using an endoscopic port. The mean age in years was 62 years (range, 43-84 years). Six of 18 patients (33%) died before discharge, and 2 others (11%) died after at least 1 month of survival. Of 12 initial survivors, all were discharged to a rehabilitation or nursing facility. Complete hematoma evacuation was achieved in 7 of 18 patients, with the remaining 11 having a partial evacuation. The patients who died (n = 6) before discharge were statistically more likely to have a left-sided hemorrhage, partial evacuation, or older age than the survivors; death at least 1  month after evacuation was additionally associated with greater preoperative hematoma volumes. Our series demonstrates that endoscopic port surgery for acute intracerebral hematoma evacuation has the ability to achieve significant decompression of large and deep-seated hematomas. Patient age, extent of evacuation, laterality, and preoperative hematoma volume appear to influence patient outcome. Most overall outcomes remain poor. Future studies are necessary to determine if surgical evacuation is in fact superior to best medical treatment and if so, to validate, refute, or further identify characteristics that define surgical candidates. Georg Thieme Verlag KG Stuttgart · New York.

Suction evacuation of hemothorax: A prospective study.

PubMed

Savage, Stephanie A; Cibulas, George A; Ward, Tyler A; Davis, Corinne A; Croce, Martin A; Zarzaur, Ben L

2016-07-01

Although tube thoracostomy is a common procedure after thoracic trauma, incomplete evacuation of fluid places the patient at risk for retained hemothorax. As little as 300 to 500 cm of blood may result in the need for an additional thoracostomy tube or, in more severe cases, lung entrapment and empyema. We hypothesized that suction evacuation of the thoracic cavity before tube placement would decrease the incidence of late complications. Patients requiring tube thoracostomy within 96 hours of admission were prospectively identified and underwent suction evacuation of the pleural space (SEPS) before tube placement. These patients were compared to historical controls without suction evacuation. Demographics, admission vital signs, laboratory values, details of chest tube placement, and outcomes were collected on all patients. Multivariable logistic regression was used to compare outcomes between groups. A total of 199 patients were identified, consisting of 100 retrospective controls and 99 SEPS patients. There were no differences in age, sex, admission injury severity score or chest abbreviated injury score, admission laboratory values or vital signs, or hospital length of stay. Mean (SD) volume of hemothorax in SEPS patients was 220 (297) cm; with only 48% having a volume greater than 100 cm at the time of tube placement. Three patients developed empyema, and 19 demonstrated retained blood; there was no difference between SEPS and control patients. Suction evacuation of the pleural space was significantly protective against recurrent pneumothorax after chest tube removal (odds ratio, 0.332; 95% confidence interval, 0.148-0.745). Preemptive suction evacuation of the thoracic cavity did not have a significant impact on subsequent development of retained hemothorax or empyema. Suction evacuation of the pleural space significantly decreased incidence of recurrent pneumothorax after thoracostomy removal. Although the mechanism is unclear, such a benefit may make this simple procedure worthwhile. A larger sample size is required for validation and to determine if preemptive thoracic evacuation has a clinical benefit. Therapeutic/care management study, level IV.

Automatic smoke evacuation in laparoscopic surgery: a simplified method for objective evaluation.

PubMed

Takahashi, Hidekazu; Yamasaki, Makoto; Hirota, Masashi; Miyazaki, Yasuaki; Moon, Jeong Ho; Souma, Yoshihito; Mori, Masaki; Doki, Yuichiro; Nakajima, Kiyokazu

2013-08-01

Although its theoretical usefulness has been reported, the true value of automatic smoke evacuation system in laparoscopic surgery remains unknown. This is mainly due to the lack of objective evaluation. The purpose of this study was to determine the efficacy of the automatic smoke evacuator in laparoscopic surgery, by real-time objective evaluation system using an industrial smoke-detection device. Six pigs were used in this study. Three surgical ports were placed and electrosurgical smoke was generated in a standard fashion, using either a high-frequency electrosurgical unit (HF-ESU) or laparosonic coagulating shears (LCS). The smoke was evacuated immediately in the evacuation group but not in the control nonevacuation group. The laparoscopic field-of-view was subjectively evaluated by ten independent surgeons. The composition of the surgical smoke was analyzed by mass spectrometry. The residual smoke in the abdominal cavity was aspirated manually into a smoke tester, and stains on a filter paper were image captured, digitized, and semiquantified. Subjective evaluation indicated superior field-of-view in the evacuation group, compared with the control, at 15 s after activation of the HF-ESU (P < 0.05). The smoke comprised various chemical compounds, including known carcinogens. The estimated volume of intra-abdominal residual smoke after activation of HF-ESU was significantly lower in the evacuation group (47.4 ± 16.6) than the control (76.7 ± 2.4, P = 0.0018). Only marginal amount of surgical smoke was detected in both groups after LCS when the tissue pad was free from burnt tissue deposits. However, the amount was significantly lower in the evacuation group (21.3 ± 10.7) than the control (75 ± 39.9, P = 0.044) when the tissue pad contained tissue sludge. Automatic smoke evacuation provides better field-of-view and reduces the risk of exposure to harmful compounds.

Canada's evacuation policy for pregnant First Nations women: Resignation, resilience, and resistance.

PubMed

Lawford, Karen M; Giles, Audrey R; Bourgeault, Ivy L

2018-02-10

Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. Although there are a few First Nations communities in Canada that have re-established community birthing and Aboriginal midwifery is growing, most First Nations communities are still reliant on the evacuation policy for labour and birthing services. In one Canadian province, Manitoba, First Nations women are evacuated to The Pas, Thompson, or Winnipeg but most - including all women with high-risk pregnancies - go to Winnipeg. To contribute scholarship that describes First Nations women's and community members' experiences and perspectives of Health Canada's evacuation policy in Manitoba. Applying intersectional theory to data collected through 12 semi-structured interviews with seven women and five community members (four females, one male) in Manitoba who had experienced the evacuation policy. The data were analyzed thematically, which revealed three themes: resignation, resilience, and resistance. The theme of resignation was epitomized by the quote, "Nobody has a choice." The ability to withstand and endure the evacuation policy despite poor or absent communication and loneliness informed of resilience. Resistance was demonstrated by women who questioned the necessity and requirement of evacuation for labour and birth. In one instance, resistance took the form of a planned homebirth with Aboriginal registered midwives. There is a pressing need to improve the maternity care services that First Nations women receive when they are evacuated out of their communities, particularly when understood from the specific legal and constitutional position of First Nations women in Manitoba. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

A Participatory Agent-Based Simulation for Indoor Evacuation Supported by Google Glass.

PubMed

Sánchez, Jesús M; Carrera, Álvaro; Iglesias, Carlos Á; Serrano, Emilio

2016-08-24

Indoor evacuation systems are needed for rescue and safety management. One of the challenges is to provide users with personalized evacuation routes in real time. To this end, this project aims at exploring the possibilities of Google Glass technology for participatory multiagent indoor evacuation simulations. Participatory multiagent simulation combines scenario-guided agents and humans equipped with Google Glass that coexist in a shared virtual space and jointly perform simulations. The paper proposes an architecture for participatory multiagent simulation in order to combine devices (Google Glass and/or smartphones) with an agent-based social simulator and indoor tracking services.

Nonimaging concentrators for solar thermal energy

NASA Astrophysics Data System (ADS)

Winston, R.; Gallagher, J. J.

1980-03-01

A small experimental solar collector test facility was used to explore applications of nonimaging optics for solar thermal concentration in three substantially different configurations: a single stage system with moderate concentration on an evacuated absorber (a 5.25X evacuated tube Compound Parabolic Concentrator or CPC), a two stage system with high concentration and a non-evacuated absorber (a 16X Fresnel lens/CPC type mirror) and moderate concentration single stage systems with non-evacuated absorbers for lower temperature (a 3X and a 6.5X CPC). Prototypes of each of these systems were designed, built and tested. The performance characteristics are presented.

VR-simulation cataract surgery in non-experienced trainees: evolution of surgical skill

NASA Astrophysics Data System (ADS)

Söderberg, Per; Erngrund, Markus; Skarman, Eva; Nordh, Leif; Laurell, Carl-Gustaf

2011-03-01

Conclusion: The current data imply that the performance index as defined herein is a valid measure of the performance of a trainee using the virtual reality phacoemulsification simulator. Further, the performance index increase linearly with measurement cycles for less than five measurement cycles. To fully use the learning potential of the simulator more than four measurement cycles are required. Materials and methods: Altogether, 10 trainees were introduced to the simulator by an instructor and then performed a training program including four measurement cycles with three iterated measurements of the simulation at the end of each cycle. The simulation characteristics was standardized and defined in 14 parameters. The simulation was measured separately for the sculpting phase in 21 variables, and for the evacuation phase in 22 variables. A performance index based on all measured variables was estimated for the sculpting phase and the evacuation phase, respectively, for each measurement and the three measurements for each cycle were averaged. Finally, the performance as a function of measurement cycle was estimated for each trainee with regression, assuming a straight line. The estimated intercept and inclination coefficients, respectively, were finally averaged for all trainees. Results: The performance increased linearly with the number of measurement cycles both for the sculpting and for the evacuation phase.

Definition and Means of Maintaining the Emergency Notification and Evacuation System Portion of the Plutonium Finishing Plant (PFP) Safety Envelope

DOE Office of Scientific and Technical Information (OSTI.GOV)

WHITE, W.F.

2000-04-04

The purpose of this document is to provide the definition and means of maintaining the safety envelope (SE) for the Emergency Notification and Evacuation System (ENES). Together with the appendices, it provides: (1) The system requirements for determining system operability (Section 3.0); (2) Evaluations of equipment to determine the safety boundary for the system (Section 4.0); (3) List of system drawings that are annotated to show the SE boundaries (Appendix A); (4) Identification of the SE equipment by reference to systems and drawings (Appendix B); (5) Requirements for the individual SE equipment (Section 4.0); and (6) A list of themore » operational and surveillance procedures necessary to operate and maintain the system equipment within the SE (Sections 5.0 and 6.0). The Private Automatic Exchange (PAX) phones and PAX switchers are outside the safety envelope defined in WHC-SD-CP-OSR-010, Section 5.4.10, ''Safety Communication and Alarm Systems,'' Section 5.4.1 0.1, ''Major Components and Operating Characteristics,'' and Section 5.4.10.1.12, ''PAX System.'' The PAX override microphone system maintains the safety envelope, and functions as a backup to the evacuation sirens during an emergency.« less

An indoor augmented reality mobile application for simulation of building evacuation

NASA Astrophysics Data System (ADS)

Sharma, Sharad; Jerripothula, Shanmukha

2015-03-01

Augmented Reality enables people to remain connected with the physical environment they are in, and invites them to look at the world from new and alternative perspectives. There has been an increasing interest in emergency evacuation applications for mobile devices. Nearly all the smart phones these days are Wi-Fi and GPS enabled. In this paper, we propose a novel emergency evacuation system that will help people to safely evacuate a building in case of an emergency situation. It will further enhance knowledge and understanding of where the exits are in the building and safety evacuation procedures. We have applied mobile augmented reality (mobile AR) to create an application with Unity 3D gaming engine. We show how the mobile AR application is able to display a 3D model of the building and animation of people evacuation using markers and web camera. The system gives a visual representation of a building in 3D space, allowing people to see where exits are in the building through the use of a smart phone or tablets. Pilot studies were conducted with the system showing its partial success and demonstrated the effectiveness of the application in emergency evacuation. Our computer vision methods give good results when the markers are closer to the camera, but accuracy decreases when the markers are far away from the camera.

Factors Associated with Maintaining the Mental Health of Employees after the Fukushima Nuclear Disaster: Findings from Companies Located in the Evacuation Area

PubMed Central

Suzuki, Yuriko; Goto, Aya; Yasumura, Seiji

2017-01-01

After the nuclear disaster in Fukushima on 11 March 2011, some businesses were permitted to continue operating even though they were located in the evacuation area designated by the Japanese government. The aim of this study was to examine differences in the mental health status, workplace, living environment, and lifestyle of employees in the evacuation and non-evacuation areas. We also investigated factors related to their mental health status. Data for this cross-sectional study were collected from the questionnaire responses of 647 employees at three medium-sized manufacturing companies in the evacuation and non-evacuation areas. Through a cross-tabulation analysis, employees who worked at companies in the evacuation areas showed an increase in the duration of overtime work, work burden, and commute time, and had experienced separation from family members due to the radiation disaster and perceived radiation risks. The results of a multivariate logistic regression analysis showed that, even in a harsh workplace and living environment, being younger, participating regularly in physical activity, having a social network (Lubben Social Network Scale-6 ≤ 12), laughing frequently, and feeling satisfied with one’s workplace and domestic life were significantly associated with maintaining a healthy mental health status after the disaster. These findings are applicable for workers’ health management measures after disasters. PMID:29301235

Factors Associated with Maintaining the Mental Health of Employees after the Fukushima Nuclear Disaster: Findings from Companies Located in the Evacuation Area.

PubMed

Orui, Masatsugu; Suzuki, Yuriko; Goto, Aya; Yasumura, Seiji

2017-12-31

After the nuclear disaster in Fukushima on 11 March 2011, some businesses were permitted to continue operating even though they were located in the evacuation area designated by the Japanese government. The aim of this study was to examine differences in the mental health status, workplace, living environment, and lifestyle of employees in the evacuation and non-evacuation areas. We also investigated factors related to their mental health status. Data for this cross-sectional study were collected from the questionnaire responses of 647 employees at three medium-sized manufacturing companies in the evacuation and non-evacuation areas. Through a cross-tabulation analysis, employees who worked at companies in the evacuation areas showed an increase in the duration of overtime work, work burden, and commute time, and had experienced separation from family members due to the radiation disaster and perceived radiation risks. The results of a multivariate logistic regression analysis showed that, even in a harsh workplace and living environment, being younger, participating regularly in physical activity, having a social network (Lubben Social Network Scale-6 ≤ 12), laughing frequently, and feeling satisfied with one's workplace and domestic life were significantly associated with maintaining a healthy mental health status after the disaster. These findings are applicable for workers' health management measures after disasters.

Changes in population evacuation potential for tsunami hazards in Seward, Alaska, since the 1964 Good Friday earthquake

USGS Publications Warehouse

Wood, Nathan J.; Schmidtlein, Mathew C.; Peters, Jeff

2014-01-01

Pedestrian evacuation modeling for tsunami hazards typically focuses on current land-cover conditions and population distributions. To examine how post-disaster redevelopment may influence the evacuation potential of at-risk populations to future threats, we modeled pedestrian travel times to safety in Seward, Alaska, based on conditions before the 1964 Good Friday earthquake and tsunami disaster and on modern conditions. Anisotropic, path distance modeling is conducted to estimate travel times to safety during the 1964 event and in modern Seward, and results are merged with various population data, including the location and number of residents, employees, public venues, and dependent care facilities. Results suggest that modeled travel time estimates conform well to the fatality patterns of the 1964 event and that evacuation travel times have increased in modern Seward due to the relocation and expansion of port and harbor facilities after the disaster. The majority of individuals threatened by tsunamis today in Seward are employee, customer, and tourist populations, rather than residents in their homes. Modern evacuation travel times to safety for the majority of the region are less than wave arrival times for future tectonic tsunamis but greater than arrival times for landslide-related tsunamis. Evacuation travel times will likely be higher in the winter time, when the presence of snow may constrain evacuations to roads.

Initial multicenter technical experience with the Apollo device for minimally invasive intracerebral hematoma evacuation.

PubMed

Spiotta, Alejandro M; Fiorella, David; Vargas, Jan; Khalessi, Alexander; Hoit, Dan; Arthur, Adam; Lena, Jonathan; Turk, Aquilla S; Chaudry, M Imran; Gutman, Frederick; Davis, Raphael; Chesler, David A; Turner, Raymond D

2015-06-01

No conventional surgical intervention has been shown to improve outcomes for patients with spontaneous intracerebral hemorrhage (ICH) compared with medical management. We report the initial multicenter experience with a novel technique for the minimally invasive evacuation of ICH using the Penumbra Apollo system (Penumbra Inc, Alameda, California). Institutional databases were queried to perform a retrospective analysis of all patients who underwent ICH evacuation with the Apollo system from May 2014 to September 2014 at 4 centers (Medical University of South Carolina, Stony Brook University, University of California at San Diego, and Semmes-Murphy Clinic). Cases were performed either in the neurointerventional suite, operating room, or in a hybrid operating room/angiography suite. Twenty-nine patients (15 female; mean age, 62 ± 12.6 years) underwent the minimally invasive evacuation of ICH. Six of these parenchymal hemorrhages had an additional intraventricular hemorrhage component. The mean volume of ICH was 45.4 ± 30.8 mL, which decreased to 21.8 ± 23.6 mL after evacuation (mean, 54.1 ± 39.1% reduction; P < .001). Two complications directly attributed to the evacuation attempt were encountered (6.9%). The mortality rate was 13.8% (n = 4). Minimally invasive evacuation of ICH and intraventricular hemorrhage can be achieved with the Apollo system. Future work will be required to determine which subset of patients are most likely to benefit from this promising technology.

Road infrastructure resilience to tsunami in Cilegon

NASA Astrophysics Data System (ADS)

Arini, Srikandi Wahyu; Sumabrata, Jachrizal

2017-11-01

Indonesia is vulnerable to natural disasters. The highest number of natural disaster occurs on the west side of Java Island with the tsunami as the most deadly. Cilegon, a densely populated city with high industrial activity is located on the west coast of Java Island with a gently sloping topography, hence it is vulnerable to tsunami. Simulations conducted by the National Disaster Management Authority indicates that earthquakes with epicenters in the Sunda strait will cause tsunamis which can sweep away the whole industrial area in one hour. The availability of evacuation routes which can accommodate the evacuation of large numbers of people within a short time is required. Road infrastructure resilience is essential to support the performance of the evacuation routes. Poor network resilience will reduce mobility and accessibility during the evacuation. The objectives of this paper are to analyze the impact of the earthquake-generated tsunami on the evacuation routes and to simulate and analyze the performance of existing evacuation routes in Cilegon. The limitations of the modeling approaches including the current and future challenges in evacuation transport research and its applications are also discussed. The conclusion from this study is accurate data source are needed to build a more representative model and predict the areas susceptible to tsunamis vulnerable areas and to construct cogent tsunami mitigation plans and actions for the most vulnerable areas.

Task two : literature search for Federal Highway Administration (ITS-JPO) : assessment of state of the practice and state of the art in evacuation transportation management

DOT National Transportation Integrated Search

2006-01-01

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

Task three : technical memorandum for Federal Highway Administration (ITS-JPO) on case studies : assessment of state of the practice and state of the art in evacuation transportation management

DOT National Transportation Integrated Search

2006-01-01

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

A materials test system for static compression at elevated temperatures

NASA Astrophysics Data System (ADS)

Korellis, J. S.; Steinhaus, C. A.; Totten, J. J.

1992-06-01

This report documents modifications to our existing computer-controlled compression testing system to allow elevated temperature testing in an evacuated environment. We have adopted an 'inverse' design configuration where the evacuated test volume is located within the induction heating coil, eliminating the expense and minimizing the evacuation time of a much larger traditional vacuum chamber.

Getting out of harm's way - evacuation from tsunamis

USGS Publications Warehouse

Jones, Jeanne M.; Wood, Nathan J.; Gordon, Leslie C.

2015-01-01

Maps of travel time can be used by emergency managers and community planners to identify where to focus evacuation training and tsunami education. The tool can also be used to examine the potential benefits of vertical-evacuation structures, which are buildings or berms designed to provide a local high ground in low-lying areas of the hazard zone. 

Wildfire evacuation and its alternatives: perspectives from four United States' communities

Treesearch

Sarah McCaffrey; Alan Rhodes; Melanie Stidham

2015-01-01

Recent years have seen growing interest within the United States fire management community in exploring alternatives to the standard approach of evacuating entire populations that are threatened by a wildfire. There has been particular interest in what can be learned from the Australian approach, whereby residents choose whether or not to evacuate under the '...

Evacuation Preparedness in the Event of Fire in Intensive Care Units in Sweden: More is Needed.

PubMed

Löfqvist, Erika; Oskarsson, Åsa; Brändström, Helge; Vuorio, Alpo; Haney, Michael

2017-06-01

Introduction Hospitals, including intensive care units (ICUs), can be subject to threat from fire and require urgent evacuation. Hypothesis The hypothesis was that the current preparedness for ICU evacuation for fire in the national public hospital system in a wealthy country was very good, using Sweden as model. An already validated questionnaire for this purpose was adapted to national/local circumstances and translated into Swedish. It aimed to elicit information concerning fire response planning, personnel education, training, and exercises. Questionnaire results (yes/no answers) were collected and answers collated to assess grouped responses. Frequencies of responses were determined. While a written hospital plan for fire response and evacuation was noted by all responders, personnel familiarity with the plan was less frequent. Deficiencies were reported concerning all categories: lack of written fire response plan for ICU, lack of personnel education in this, and lack of practical exercises to practice urgent evacuation in the event of fire. These findings were interpreted as an indication of risk for worse consequences for patients in the event of fire and ICU evacuation among the hospitals in the country that was assessed, despite clear regulations and requirements for these. The exact reasons for this lack of compliance with existing laws was not clear, though there are many possible explanations. To remedy this, more attention is needed concerning recognizing risk related to lack of preparedness. Where there exists a goal of high-quality work in the ICU, this should include general leadership and medical staff preparedness in the event of urgent ICU evacuation. Löfqvist E , Oskarsson A , Brändström H , Vuorio A , Haney M . Evacuation preparedness in the event of fire in intensive care units in Sweden: more is needed. Prehosp Disaster Med. 2017;32(3):317-320.

Postnuclear disaster evacuation and chronic health in adults in Fukushima, Japan: a long-term retrospective analysis

PubMed Central

Nomura, Shuhei; Blangiardo, Marta; Tsubokura, Masaharu; Ozaki, Akihiko; Morita, Tomohiro; Hodgson, Susan

2016-01-01

Objective Japan's 2011 Fukushima Daiichi Nuclear Power Plant incident required the evacuation of over a million people, creating a large displaced population with potentially increased vulnerability in terms of chronic health conditions. We assessed the long-term impact of evacuation on diabetes, hyperlipidaemia and hypertension. Participants We considered participants in annual public health check-ups from 2008 to 2014, administrated by Minamisoma City and Soma City, located about 10–50 km from the Fukushima nuclear plant. Methods Disease risks, measured in terms of pre-incident and post-incident relative risks, were examined and compared between evacuees and non-evacuees/temporary-evacuees. We also constructed logistic regression models to assess the impact of evacuation on the disease risks adjusted for covariates. Results Data from a total of 6406 individuals aged 40–74 years who participated in the check-ups both at baseline (2008–2010) and in one or more post-incident years were analysed. Regardless of evacuation, significant post-incident increases in risk were observed for diabetes and hyperlipidaemia (relative risk: 1.27–1.60 and 1.12–1.30, respectively, depending on evacuation status and post-incident year). After adjustment for covariates, the increase in hyperlipidaemia was significantly greater among evacuees than among non-evacuees/temporary-evacuees (OR 1.18, 95% CI 1.06 to 1.32, p<0.01). Conclusions The singularity of this study is that evacuation following the Fukushima disaster was found to be associated with a small increase in long-term hyperlipidaemia risk in adults. Our findings help identify discussion points on disaster planning, including preparedness, response and recovery measures, applicable to future disasters requiring mass evacuation. PMID:26846896

Analysis of the causes of medical evacuation of injured and sick soldiers of the Polish Military Contingent in the Islamic State of Afghanistan taking part in International Security Assistance Force operations.

PubMed

Ziemba, Radosław

2012-04-01

Military casualties in Afghanistan arise in part from climatic and natural conditions that are difficult for European soldiers to endure, as well as from intense guerrilla combat with mass use of IEDs (improvised explosive devices), thus posing numerous and diverse medical problems requiring evacuation to the home country. A search of the literature revealed no comprehensive studies of the causes of medical evacuation from this theater of operations. This article is a review of medical reports of the Polish Military Contingent taking part in Operation Enduring Freedom during the period from 01 January 2010 to 31 December 2011, including an analysis of causes of all ROLE 4 medical evacuations (to the military base in Germany or to the home country). As many as 565 (5.49%) of the total of 10 294 contingent soldiers were evacuated during the analyzed period. Of these, 29% of evacuation cases were due to combat injuries, 23% to complications of respiratory tract infection, 11% to mental health problems, 11% to chronic neuralgias, 12% to complications of acute gastrointestinal infections, 4% to non-combat injuries, 3% to dental and maxillofacial problems, 2% to dermatological problems and 2% to leishmaniasis. The remaining causes included chronic organic/systemic diseases manifested during service. The main causes of medical evacuations to the home country were the consequences of combat injuries, mainly due to IED attacks. Appropriate diagnosis and early treatment of infections is also an important problem in the face of a significant number of complications resulting in evacuation of soldiers to their home country.

Agent-based Modeling with MATSim for Hazards Evacuation Planning

NASA Astrophysics Data System (ADS)

Jones, J. M.; Ng, P.; Henry, K.; Peters, J.; Wood, N. J.

2015-12-01

Hazard evacuation planning requires robust modeling tools and techniques, such as least cost distance or agent-based modeling, to gain an understanding of a community's potential to reach safety before event (e.g. tsunami) arrival. Least cost distance modeling provides a static view of the evacuation landscape with an estimate of travel times to safety from each location in the hazard space. With this information, practitioners can assess a community's overall ability for timely evacuation. More information may be needed if evacuee congestion creates bottlenecks in the flow patterns. Dynamic movement patterns are best explored with agent-based models that simulate movement of and interaction between individual agents as evacuees through the hazard space, reacting to potential congestion areas along the evacuation route. The multi-agent transport simulation model MATSim is an agent-based modeling framework that can be applied to hazard evacuation planning. Developed jointly by universities in Switzerland and Germany, MATSim is open-source software written in Java and freely available for modification or enhancement. We successfully used MATSim to illustrate tsunami evacuation challenges in two island communities in California, USA, that are impacted by limited escape routes. However, working with MATSim's data preparation, simulation, and visualization modules in an integrated development environment requires a significant investment of time to develop the software expertise to link the modules and run a simulation. To facilitate our evacuation research, we packaged the MATSim modules into a single application tailored to the needs of the hazards community. By exposing the modeling parameters of interest to researchers in an intuitive user interface and hiding the software complexities, we bring agent-based modeling closer to practitioners and provide access to the powerful visual and analytic information that this modeling can provide.

Non-battle injuries among U.S. Army soldiers deployed to Afghanistan and Iraq, 2001-2013.

PubMed

Patel, Avni A; Hauret, Keith G; Taylor, Bonnie J; Jones, Bruce H

2017-02-01

Many non-battle injuries among deployed soldiers are due to occupational-related tasks. Given that non-battle injuries are a significant cause of morbidity and mortality, occupational safety and health are of great concern to the military. Some of the leading causes of non-battle injuries in the military are also common in non-military occupational settings. Nationally, falls and motor-vehicle accidents are leading causes of non-fatal occupational injuries in the civilian workforce. The objective of this research is to identify the leading causes, types, and anatomic locations of non-fatal non-battle injuries in Afghanistan and Iraq. Non-battle injuries were identified from medical air evacuation records. Causes of air evacuated injuries were identified and coded using the diagnosis and narrative patient history in the air evacuation records. Descriptive statistics were used to report the air evacuated non-battle injury rates, causes, injury types, and anatomic locations. Between 2001 and 2013, there were 68,349 medical air evacuations from Afghanistan and Iraq. Non-battle injuries accounted for 31% of air evacuations from Afghanistan and 34% from Iraq. These injuries were the leading diagnosis category for air evacuations. The three leading causes of injury for Afghanistan and Iraq, respectively, were sports/physical training (23% and 24%), falls/jumps (19% and 16%), and military vehicle-related accidents (8% and 11%). The leading injury types were fractures (21%), overuse pain and inflammation (16%), and dislocations (11%). Given that over 30% of medical evacuations of soldiers result from non-battle injuries, prevention of such conditions would substantially enhance military readiness during combat. Copyright © 2016 National Safety Council and Elsevier Ltd. All rights reserved.

Use of Subdural Evacuating Port System Following Open Craniotomy with Excision of Native Dura and Membranes for Management of Chronic Subdural Hematoma.

PubMed

Cage, Tene; Bach, Ashley; McDermott, Michael W

2017-04-26

An 86-year-old woman was admitted to the intensive care unit with a chronic subdural hematoma (CSDH) and rapid onset of worsening neurological symptoms. She was taken to the operating room for a mini-craniotomy for evacuation of the CSDH including excision of the dura and CSDH membrane. Postoperatively, a subdural evacuation port system (SEPS) was integrated into the craniotomy site and left in place rather than a traditional subdural catheter drain to evacuate the subdural space postoperatively. The patient had a good recovery and improvement of symptoms after evacuation and remained clinically well after the SEPS was removed. We offer the technique of dura and CSDH membrane excision plus SEPS drain as an effective postoperative alternative to the standard craniotomy leaving the native dura intact with traditional subdural drain that overlies the cortical surface of the brain in treating patients with CSDH.

Unsuitability of evacuated tubes for monitoring heparin therapy by activated partial thromboplastin time.

PubMed Central

Heyns, A D; van den Berg, D J; Kleynhans, P H; du Toit, P W

1981-01-01

Activated partial thromboplastin times (APTT) for monitoring heparin therapy for venous thromboembolism tended to be inappropriately short if blood was collected in commercially available evacuated glass tubes. Five types of evacuated tubes marketed under the trade names Vacutainer and Venoject were examined. The APTT of heparinized blood collected in these tubes correlated poorly (r = 0.04 to 4 = 0.25) with that of blood samples from the same patients collected in plastic tubes. Most of the evacuated tube APTT were shorter than that of blood collected in plastic or siliconised glass tubes, but the results were unpredictable and varied from tube to tube and from batch to batch. This effect on heparin is apparently due to an unidentified substances which is eluted from the rubber stoppers of the tubes. Heparin control according to the APTT blood collected in these evacuated tubes is hazardous. PMID:7462439

Tsunami Evacuation Plan for the City of Tangier-Morocco

NASA Astrophysics Data System (ADS)

Benchekroun, Sabah; Omira, Rachid; Baptista, Maria Ana; Arbi Toto, El

2016-04-01

Tsunami evacuation plan is an important tool to mitigate the tsunami impact. It is the most efficient way to save human lives, well before the waves reach the threatened coastal area, by providing evacuation routes and appropriate shelters. In this study, we propose a tsunami evacuation plan for the city of Tangier-Morocco. This plan is designed considering the tsunami threat from the tsunamigenic sources located in the SW Iberia Margin and using the inundation maps of the worst case to define the limit of flooding area. The evacuation plan is elaborated through modelling the required time for the threatened coastal population to reach the shelters. Results of this study will be useful for decision makers and local authorities in preventing the community resiliency for tsunami hazard. This work received funding from collaborative project ASTARTE - Assessment Strategy and Risk Reduction for Tsunamis in Europe Grant 603839, FP7.

[Disturbances of gastrointestinal motility of the stomach in patients with chronic gastric erosions and biliary tract disease].

PubMed

Svintsitskyĭ, A S; Solovĭova, H A

2012-12-01

Article dwells on comparison data about motor function of the stomach in the three groups of patients: with gastric erosions and biliary tract diseases, duodenal ulcer disease, chronic gastritis. It is shown, that patients with gastric erosions and biliary tract diseases are characterized by slower evacuation function of the stomach, hypotonus of the stomach. Frequency of duodenal reflux in this group of patients is very high (85,9 %).

Management of Recurrent Subdural Hematomas.

PubMed

Desai, Virendra R; Scranton, Robert A; Britz, Gavin W

2017-04-01

Subdural hematomas commonly recur after surgical evacuation, at a rate of 2% to 37%. Risk factors for recurrence can be patient related, radiologic, or surgical. Patient-related risk factors include alcoholism, seizure disorders, coagulopathy, and history of ventriculoperitoneal shunt. Radiologic factors include poor brain reexpansion postoperatively, significant subdural air, greater midline shift, heterogeneous hematomas (layered or multi-loculated), and higher-density hematomas. Surgical factors include lack of or poor postoperative drainage. Most recurrent hematomas are managed successfully with burr hole craniostomies with postoperative closed-system drainage. Refractory hematomas may be managed with a variety of techniques, including craniotomy or subdural-peritoneal shunt placement. Copyright © 2016 Elsevier Inc. All rights reserved.

Postoperative digestive function after radical versus conservative surgical philosophy for deep endometriosis infiltrating the rectum.

PubMed

Roman, Horace; Vassilieff, Maud; Tuech, Jean Jacques; Huet, Emmanuel; Savoye, Guillaume; Marpeau, Loïc; Puscasiu, Lucian

2013-05-01

To compare delayed digestive outcomes in women managed by two different surgical philosophies: a radical approach mainly related to colorectal resection, and a conservative approach involving rectal shaving and rectal nodule excision. "Before and after" comparative retrospective study. University tertiary referral center. Seventy-five patients managed by surgery for deep endometriosis infiltrating the rectum. Twenty-four women were managed during a period when surgeons pursued a radical philosophy toward treatment, and 51 women were managed during a period when a conservative philosophy was adopted. Standardized gastrointestinal questionnaires: the Gastrointestinal Quality of Life Index, the Knowles-Eccersley-Scott Symptom Questionnaire, the Bristol Stool Score, and the Fecal Incontinence Quality of Life Score. Preoperative patient characteristics, rectal nodule features, and associated localizations of the disease were comparable between the two groups. During the radical period, colorectal resection was carried out in 67% of patients, whereas during the second period only 20% of women underwent colorectal resection. Women managed according to the conservative philosophy had significantly improved results on the Knowles-Eccersley-Scott Symptom Questionnaire, Gastrointestinal Quality of Life Index, and depression/self-perception Fecal Incontinence Quality of Life Score, and significantly improved values for various items related to postoperative constipation: unsuccessful evacuatory attempts, feeling incomplete evacuation, abdominal pain, time taken to evacuate, difficulty evacuating causing a painful effort, and stool consistency. It seems that reducing the rate of colorectal resection leads to better functional outcomes in women presenting with rectal endometriosis, lending support to the conservative surgical philosophy over mandatory colorectal resection. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Alternatives to evacuation during wildland fire: Exploring adaptive capacity in one Idaho community

Treesearch

Travis B. Paveglio; Matthew S. Caroll; Pamela J. Jakes

2010-01-01

The use of alternatives to evacuation during wildfire events continues to be an intensely debated strategy in the professional and policy circles of numerous fire-prone countries. The most recent chapter comes in response to the Black Saturday Fires in Australia, which has led to policy changes concerning alternatives to evacuation in both Australia and USA. This study...

Weathering the storm: challenges to nurses providing care to nursing home residents during hurricanes.

PubMed

Hyer, Kathryn; Brown, Lisa M; Christensen, Janelle J; Thomas, Kali S

2009-11-01

This article documents the experience of 291 Florida nursing homes during the 2004 hurricane season. Using quantitative and qualitative methods, the authors described and compared the challenges nurses encountered when evacuating residents with their experiences assisting residents of facilities that sheltered in place. The primary concerns for evacuating facilities were accessing appropriate evacuation sites for residents and having ambulance transportation contracts honored. The main issue for facilities that sheltered in place was the length of time it took for power to be restored. Barriers to maintaining resident health during disasters for those who evacuated or sheltered in place are identified.

[Diary of a hospital evacuation. Discovery of a 5 hundredweight bomb from World War II].

PubMed

Katter, I; Kunitz, O; Deller, A

2008-07-01

The discovery of an aircraft bomb from World War II made the complete evacuation of a tertiary care hospital with 629 beds and 17 specialist departments including a neonatal intensive care unit necessary. Some months before an alarm plan had been issued and a fire practice had been carried out which made it obvious to all concerned how important such measures are. Nevertheless, more room for improvement could be learned from the evacuation, in particular the rapid classification of the patients into categories and the fact that 20-30% of the patients needed stretcher-based transport for evacuation.

Fluid Transient Analysis during Priming of Evacuated Line

NASA Technical Reports Server (NTRS)

Bandyopadhyay, Alak; Majumdar, Alok K.; Holt, Kimberley

2017-01-01

Water hammer analysis in pipe lines, in particularly during priming into evacuated lines is important for the design of spacecraft and other in-space application. In the current study, a finite volume network flow analysis code is used for modeling three different geometrical configurations: the first two being straight pipe, one with atmospheric air and other with evacuated line, and the third case is a representation of a complex flow network system. The numerical results show very good agreement qualitatively and quantitatively with measured data available in the literature. The peak pressure and impact time in case of straight pipe priming in evacuated line shows excellent agreement.

Transverse Mode Electron Beam Microwave Generator

NASA Technical Reports Server (NTRS)

Wharton, Lawrence E.

1994-01-01

An electron beam microwave device having an evacuated interaction chamber to which are coupled a resonant cavity which has an opening between the resonant cavity and the evacuated interaction chamber and an electron gun which causes a narrow beam of electrons to traverse the evacuated interaction chamber. The device also contains a mechanism for feeding back a microwave electromagnetic field from the resonant cavity to the evacuated interaction chamber in such a way as to modulate the direction of propagation of the electron beam, thereby further amplifyjng the microwave electromagnetic field. Furthermore, provision is made for coupling the electromagnetic field out of the electron beam microwave device.

Effect of form of obstacle on speed of crowd evacuation

NASA Astrophysics Data System (ADS)

Yano, Ryosuke

2018-03-01

This paper investigates the effect of the form of an obstacle on the time that a crowd takes to evacuate a room, using a toy model. Pedestrians are modeled as active soft matter moving toward a point with intended velocities. An obstacle is placed in front of the exit, and it has one of four shapes: a cylindrical column, a triangular prism, a quadratic prism, or a diamond prism. Numerical results indicate that the evacuation-completion time depends on the shape of the obstacle. Obstacles with a circular cylinder (C.C.) shape yield the shortest evacuation-completion time in the proposed model.

A Participatory Agent-Based Simulation for Indoor Evacuation Supported by Google Glass

PubMed Central

Sánchez, Jesús M.; Carrera, Álvaro; Iglesias, Carlos Á.; Serrano, Emilio

2016-01-01

Indoor evacuation systems are needed for rescue and safety management. One of the challenges is to provide users with personalized evacuation routes in real time. To this end, this project aims at exploring the possibilities of Google Glass technology for participatory multiagent indoor evacuation simulations. Participatory multiagent simulation combines scenario-guided agents and humans equipped with Google Glass that coexist in a shared virtual space and jointly perform simulations. The paper proposes an architecture for participatory multiagent simulation in order to combine devices (Google Glass and/or smartphones) with an agent-based social simulator and indoor tracking services. PMID:27563911

To Evacuate or Shelter in Place: Implications of Universal Hurricane Evacuation Policies on Nursing Home Residents

PubMed Central

Dosa, David; Hyer, Kathryn; Thomas, Kali; Swaminathan, Shailender; Feng, Zhanlian; Brown, Lisa; Mor, Vincent

2011-01-01

Objective To examine the differential morbidity/mortality associated with evacuation versus sheltering in place for nursing home (NH) residents exposed to the 4 most recent Gulf-hurricanes Methods Observational study using Medicare claims, and NH data sources. We compared the differential mortality/morbidity for long-stay residents exposed to 4 recent hurricanes (Katrina, Rita, Gustav, and Ike) relative to those residing at the same NHs over the same time periods during the prior 2 non-hurricane years as a control. Using an instrumental variable analysis, we then evaluated the independent effect of evacuation on outcomes at 90 days. Results Among 36,389 NH residents exposed to a storm, the 30 and 90 day mortality/hospitalization rates increased compared to non-hurricane control years. There were a cumulative total of 277 extra deaths and 872 extra hospitalizations at 30 days. At 90 days, 579 extra deaths and 544 extra hospitalizations were observed. Using the instrumental variable analysis, evacuation increased the probability of death at 90 days from 2.7-5.3% and hospitalization by 1.8-8.3%, independent of other factors. Conclusion Among residents exposed to hurricanes, evacuation significantly exacerbated subsequent morbidity/mortality. PMID:21885350

Influences of exit and stair conditions on human evacuation in a dormitory

NASA Astrophysics Data System (ADS)

Lei, Wenjun; Li, Angui; Gao, Ran; Wang, Xiaowei

2012-12-01

Evacuation processes of students are investigated by experiment and simulation. The experiment is performed for students evacuating from a dormitory with an exit and stairs. FDS+Evac is proposed to simulate the exit and stair dynamics of occupant evacuation. Concerning the exit and stair widths, we put forward some useful standpoints. Good agreement is achieved between the predicted results and experimental results. With the increase of exit width, a significant stratification phenomenon will be found in flow rate. Stratification phenomenon is that two different stable flow rates will emerge during the evacuation. And the flow rate curve looks like a ladder. The larger the exit width, the earlier the stratification phenomenon appears. When exit width is more than 2.0 m, the flow rate of each exit width is divided into two stable stages, and the evacuation times show almost no change. The judgment that the existence of stairs causes flow stratification is reasonable. By changing the width of the stairs, we proved that judgment. The smaller the width of BC, the earlier the stratification appears. We found that scenario 5 is the most adverse circumstance. Those results are helpful in performance-based design of buildings.

Interdisciplinary modeling and analysis to reduce loss of life from tsunamis

NASA Astrophysics Data System (ADS)

Wood, N. J.

2016-12-01

Recent disasters have demonstrated the significant loss of life and community impacts that can occur from tsunamis. Minimizing future losses requires an integrated understanding of the range of potential tsunami threats, how individuals are specifically vulnerable to these threats, what is currently in place to improve their chances of survival, and what risk-reduction efforts could be implemented. This presentation will provide a holistic perspective of USGS research enabled by recent advances in geospatial modeling to assess and communicate population vulnerability to tsunamis and the range of possible interventions to reduce it. Integrated research includes efforts to characterize the magnitude and demography of at-risk individuals in tsunami-hazard zones, their evacuation potential based on landscape conditions, nature-based mitigation to improve evacuation potential, evacuation pathways and population demand at assembly areas, siting considerations for vertical-evacuation refuges, community implications of multiple evacuation zones, car-based evacuation modeling for distant tsunamis, and projected changes in population exposure to tsunamis over time. Collectively, this interdisciplinary research supports emergency managers in their efforts to implement targeted risk-reduction efforts based on local conditions and needs, instead of generic regional strategies that only focus on hazard attributes.

Fluid Line Evacuation and Freezing Experiments for Digital Radiator Concept

NASA Technical Reports Server (NTRS)

Berisford, Daniel F.; Birur, Gajanana C.; Miller, Jennifer R.; Sunada, Eric T.; Ganapathi, Gani B.; Stephan, Ryan; Johnson, Mark

2011-01-01

The digital radiator technology is one of three variable heat rejection technologies being investigated for future human-rated NASA missions. The digital radiator concept is based on a mechanically pumped fluid loop with parallel tubes carrying coolant to reject heat from the radiator surface. A series of valves actuate to start and stop fluid flow to di erent combinations of tubes, in order to vary the heat rejection capability of the radiator by a factor of 10 or more. When the flow in a particular leg is stopped, the fluid temperature drops and the fluid can freeze, causing damage or preventing flow from restarting. For this reason, the liquid in a stopped leg must be partially or fully evacuated upon shutdown. One of the challenges facing fluid evacuation from closed tubes arises from the vapor generated during pumping to low pressure, which can cause pump cavitation and incomplete evacuation. Here we present a series of laboratory experiments demonstrating fluid evacuation techniques to overcome these challenges by applying heat and pumping to partial vacuum. Also presented are results from qualitative testing of the freezing characteristics of several different candidate fluids, which demonstrate significant di erences in freezing properties, and give insight to the evacuation process.

Early waning and evacuation from Tsunami, volcano, flood and other hazards

NASA Astrophysics Data System (ADS)

Sugimoto, M.

2012-12-01

In reconsideration of the great sacrifice among the people, evacuation calls for evacuation through Japan Meteorological Agency (JMA), local governments and Medias have been drastically changed after the 2011 Tohoku tsunami in Japan. One of example is that JMA changed from forecasted concrete figure of tsunami height to one of 3 levels of tsunami height. A data shows the border between life and death is just 2 minutes of earlier evacuation in case of the 2011 tsunami. It shows how importance for communities to prompt early evacuation for survivals. However, the 2011 Tohoku tsunami revealed there is no reliable trigger to prompt early evacuation to people in case of blackout under disasters, excluding effective education. The warning call was still complicated situations in Japan in July 2012. The 2012 Northern Kyusyu downpours was at worst around 110 millimeters an hour and casualties 30 in Japan. JMA learned from the last tsunami. In this time JMA informed to local governments as a waning call "Unexpected severe rains" to local governments. However, local governments did not notice the call from JMA in the same as usual informed way. One of the local government said "We were very busy for preparing for staffs. We looked at the necessary information of the water levels of rivers and flood prevention under emergent situation" (NHK 2012). This case shows JMA's evacuation calls from upstream to midstream of local government and downstream of communities started, however upstream calls have not engaged with midstream and communities yet. Calls of early warning from upstream is still a self-centered idea for both midstream and downstream. Finally JMA could not convey a crisis mentality to local government. The head of Oarai town independently decided to use the different warning call "Order townspersons to evacuate immediately" in Ibaraki prefecture, Japan from the other municipalities in 2011 though there was not such a manuals calls in Japan. This risk communication succeeded between the local government and communities. People said I have never heard such warning call so I started evacuate soon. On the other hand, Japanese government make a strategy of level 1 tsunami height and lever 2 height. Japan is still seeking to adept at harmonizing evacuation with infrastructures to prevent. It is still not clear to solve warning issues and prevent issues. This research contributes how to struggle with these issues now in Japan.

Response, Emergency Staging, Communications, Uniform Management, and Evacuation (R.E.S.C.U.M.E.) : report on functional and performance requirements, and high-level data and communication needs.

DOT National Transportation Integrated Search

1995-06-01

INTELLIGENT VEHICLE INITIATIVE OR IVI ABSTRACT THE GOAL OF THE TRAVTEK CAMERA CAR STUDY WAS TO FURNISH A DETAILED EVALUATION OF DRIVING AND NAVIGATION PERFORMANCE, SYSTEM USABILITY, AND SAFETY FOR THE TRAVTEK SYSTEM. TO ACHIEVE THIS GOAL, AN INSTRUME...

ICU fire evacuation preparedness in London: a cross-sectional study.

PubMed

Murphy, G R F; Foot, C

2011-05-01

Hospital fires present a sporadic but significant threat to patients and staff. This is especially so within an intensive care unit (ICU) setting, due to the complexity of moving acutely unwell patients reliant on invasive monitoring and organ support. Despite an average of 500 in-hospital fires reported to the UK department of health per annum, causing 65 injuries and 1-2 fatalities, the readiness of ICUs for urgent evacuation has not been assessed. A cross-sectional survey of all 50 adult and paediatric ICUs within the London Postgraduate Deanery was conducted; neonatal units were excluded. The senior nurse at each unit was asked to complete a 90-question structured questionnaire, covering unit patient characteristics, design, equipment, training, and their evacuation plan. Thirty-five of 50 (70%) responded within 2 months of the study. Significant weaknesses were reported in unit design, equipment, and planning. Unit design was compromised by inadequate fire doors (20%), ventilation cut-outs (17%), and escape routes (up to 60%). The ability to evacuate multiple patients simultaneously may be limited by a lack of portable monitoring equipment (49% of beds) and emergency drug supplies (20% of beds). Evacuation plans were often limited in their scope (96% expected to remain on their floor; 14% had plans to obtain medications after evacuation), and not rehearsed (60%). Staff training, while well provided for permanent staff, is less so for temporary staff (34%). Forward planning for an urgent evacuation can be improved.

Evacuation of institutionalized and specialized populations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vogt, B.M.

The purpose of this research was to assess the needs of organizations caring for institutional and specialized populations when faced with a threat or hazard requiring an evacuation. Individuals within specialized populations are unlike other victims of disaster because of their inherent dependency on organizational care givers and require different management strategies on the part of organizations and agencies in an evacuation. The research sought to identify those aspects of coping strategies that have been used successfully to manage an emergency evacuation. To identify special populations that have evacuated from institutions and similar facilities over a four-year period, a computerizedmore » search was conducted of media accounts describing such events. The search yielded a total of 1024 accounts from which four major subgroups were identified: nursing homes and related care facilities, hospitals, educational institutions, and correctional facilities. A miscellaneous group including housing for the elderly, apartments and other building complexes, workplaces and factories, public facilities, and places occupied by transient populations, such as transportation units and recreational facilities, could be used for future study. Among the factors found to affect evacuations were the extent of organizational resources (such as the number of staff or other individuals available at the time of the event), the type and number of clientele, and such community characteristics as population density. The study focuses on selected organizational characteristics of health care facilities (nursing homes and related care facilities and hospitals) which have recently experienced either a partial or complete evacuation of their facilities. 165 refs., 13 tabs.« less

Optimal layout design of obstacles for panic evacuation using differential evolution

NASA Astrophysics Data System (ADS)

Zhao, Yongxiang; Li, Meifang; Lu, Xin; Tian, Lijun; Yu, Zhiyong; Huang, Kai; Wang, Yana; Li, Ting

2017-01-01

To improve the pedestrian outflow in panic situations by suitably placing an obstacle in front of the exit, it is vital to understand the physical mechanism behind the evacuation efficiency enhancement. In this paper, a robust differential evolution is firstly employed to optimize the geometrical parameters of different shaped obstacles in order to achieve an optimal evacuation efficiency. Moreover, it is found that all the geometrical parameters of obstacles could markedly influence the evacuation efficiency of pedestrians, and the best way for achieving an optimal pedestrian outflow is to slightly shift the obstacle from the center of the exit which is consistent with findings of extant literature. Most importantly, by analyzing the profiles of density, velocity and specific flow, as well as the spatial distribution of crowd pressure, we have proven that placing an obstacle in panic situations does not reduce or absorb the pressure in the region of exit, on the contrary, promotes the pressure to a much higher level, hence the physical mechanism behind the evacuation efficiency enhancement is not a pressure decrease in the region of exit, but a significant reduction of high density region by effective separation in space which finally causes the increasing of escape speed and evacuation outflow. Finally, it is clearly demonstrated that the panel-like obstacle is considerably more robust and stable than the pillar-like obstacle to guarantee the enhancement of evacuation efficiency under different initial pedestrian distributions, different initial crowd densities as well as different desired velocities.

Managed traffic evacuation using distributed sensor processing

NASA Astrophysics Data System (ADS)

Ramuhalli, Pradeep; Biswas, Subir

2005-05-01

This paper presents an integrated sensor network and distributed event processing architecture for managed in-building traffic evacuation during natural and human-caused disasters, including earthquakes, fire and biological/chemical terrorist attacks. The proposed wireless sensor network protocols and distributed event processing mechanisms offer a new distributed paradigm for improving reliability in building evacuation and disaster management. The networking component of the system is constructed using distributed wireless sensors for measuring environmental parameters such as temperature, humidity, and detecting unusual events such as smoke, structural failures, vibration, biological/chemical or nuclear agents. Distributed event processing algorithms will be executed by these sensor nodes to detect the propagation pattern of the disaster and to measure the concentration and activity of human traffic in different parts of the building. Based on this information, dynamic evacuation decisions are taken for maximizing the evacuation speed and minimizing unwanted incidents such as human exposure to harmful agents and stampedes near exits. A set of audio-visual indicators and actuators are used for aiding the automated evacuation process. In this paper we develop integrated protocols, algorithms and their simulation models for the proposed sensor networking and the distributed event processing framework. Also, efficient harnessing of the individually low, but collectively massive, processing abilities of the sensor nodes is a powerful concept behind our proposed distributed event processing algorithms. Results obtained through simulation in this paper are used for a detailed characterization of the proposed evacuation management system and its associated algorithmic components.

76 FR 15229 - Airworthiness Directives; Goodrich Evacuation Systems Approved Under Technical Standard Order...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-21

... Evacuation Systems Approved Under Technical Standard Order (TSO) TSO-C69b and Installed on Airbus Model A330-200 and -300 Series Airplanes, Model A340-200 and -300 Series Airplanes, and Model A340-541 and -642... evacuation systems approved under TSO- C69b and installed on certain Model A330-200 and -300 series airplanes...

GLOVE BOX ATTACHMENT

DOEpatents

Butts, H.L.

1962-02-13

This invention comprises a housing unit to be fitted between a glove box port and a glove so that a slidable plate within the housing seals off the glove box port for evacuation of the glove box without damage to the glove. The housing and the glove may be evacuated without damage to the glove since movement of the glove is restricted during evacuation by the slidable plate. (AEC)

Administering "Operation Pied Piper"--How the London County Council Prepared for the Evacuation of Its Schoolchildren 1938-1939

ERIC Educational Resources Information Center

Gartner, Niko

2010-01-01

In September 1939, two days before declaring war on Germany, the British government evacuated over half a million children from London to supposedly safer areas in the country. Schoolchildren went there with their teachers and infants with their mothers. Immediately after the event (and ever since) the impact of the evacuation on the children--the…

Adoption and perceptions of shelter-in-place in California's Rancho Santa Fe Fire Protection District

Treesearch

Travis B. Paveglio; Matthew S. Carroll; Pamela J. Jakes

2010-01-01

The increasing impact of wildland fire on human settlements in the USA, and a growing recognition that evacuation might not always to the safest option for those in the path of the flames, continue to spur consideration of alternatives to evacuation among the American public and its fire professionals. Alternatives to evacuation typically include the option for...

Effects of the Fort McMurray wildfires on the health of evacuated workers: follow-up of 2 cohorts

PubMed Central

Cherry, Nicola; Haynes, Whitney

2017-01-01

Background: Wildfire engulfed Fort McMurray, Alberta on May 3, 2016, leading to a total evacuation. Access to 2 active cohorts allowed us to rapidly assess health effects in those evacuated. Methods: People working in Fort McMurray who had been recruited before the fire for 2 occupational health cohort studies completed a questionnaire (online or via telephone) 3-26 weeks after evacuation. The questionnaire asked about respiratory and mental health and experiences since the fire. Results: Of the 129 participants, 109 were in the Fort McMurray area on May 3. Thirty-seven (33.9%) of the participants who were in Fort McMurray on May 3 reported a health condition, including respiratory symptoms (n = 17) and mental ill health (n = 17), immediately after the fire. At follow-up, a mean of 102 days after the fire, 11 participants (10.1%) reported a fire-related health condition, including mental ill health (n = 8) and respiratory symptoms (n = 2). There was no difference before and after the fire in use of alcohol, cigarettes, recreational drugs or medication. One in 4 participants (32 [24.6%]) had not worked since the fire, and fewer than half (58 [44.6%]) had returned to Fort McMurray. Of the 90 participants evacuated, 15 (16.7%) had scores indicative of moderate or severe anxiety or depression on the Hospital Anxiety and Depression Scale. Those evacuated had significantly higher mean anxiety (p = 0.01) and depression (p = 0.04) scores than those not evacuated. Regression modelling showed that anxiety scores were higher for women, with longer time since the fire and with evacuation to a motel. Depression scores were higher for women and with financial loss because of lack of work. Interpretation: Although evacuation was associated with higher anxiety and depression scores, persisting ill health was not widespread at early follow-up after the fire. Although these results are encouraging, these "healthy worker" results cannot be generalized to all evacuees. PMID:28819065

Effects of the Fort McMurray wildfires on the health of evacuated workers: follow-up of 2 cohorts.

PubMed

Cherry, Nicola; Haynes, Whitney

2017-08-15

Wildfire engulfed Fort McMurray, Alberta on May 3, 2016, leading to a total evacuation. Access to 2 active cohorts allowed us to rapidly assess health effects in those evacuated. People working in Fort McMurray who had been recruited before the fire for 2 occupational health cohort studies completed a questionnaire (online or via telephone) 3-26 weeks after evacuation. The questionnaire asked about respiratory and mental health and experiences since the fire. Of the 129 participants, 109 were in the Fort McMurray area on May 3. Thirty-seven (33.9%) of the participants who were in Fort McMurray on May 3 reported a health condition, including respiratory symptoms ( n = 17) and mental ill health ( n = 17), immediately after the fire. At follow-up, a mean of 102 days after the fire, 11 participants (10.1%) reported a fire-related health condition, including mental ill health ( n = 8) and respiratory symptoms ( n = 2). There was no difference before and after the fire in use of alcohol, cigarettes, recreational drugs or medication. One in 4 participants (32 [24.6%]) had not worked since the fire, and fewer than half (58 [44.6%]) had returned to Fort McMurray. Of the 90 participants evacuated, 15 (16.7%) had scores indicative of moderate or severe anxiety or depression on the Hospital Anxiety and Depression Scale. Those evacuated had significantly higher mean anxiety ( p = 0.01) and depression ( p = 0.04) scores than those not evacuated. Regression modelling showed that anxiety scores were higher for women, with longer time since the fire and with evacuation to a motel. Depression scores were higher for women and with financial loss because of lack of work. Although evacuation was associated with higher anxiety and depression scores, persisting ill health was not widespread at early follow-up after the fire. Although these results are encouraging, these "healthy worker" results cannot be generalized to all evacuees. Copyright 2017, Joule Inc. or its licensors.

Implementation Of Haversine Formula And Best First Search Method In Searching Of Tsunami Evacuation Route

NASA Astrophysics Data System (ADS)

Anisya; Yoga Swara, Ganda

2017-12-01

Padang is one of the cities prone to earthquake disaster with tsunami due to its position at the meeting of two active plates, this is, a source of potentially powerful earthquake and tsunami. Central government and most offices are located in the red zone (vulnerable areas), it will also affect the evacuation of the population during the earthquake and tsunami disaster. In this study, researchers produced a system of search nearest shelter using best-first-search method. This method uses the heuristic function, the amount of cost taken and the estimated value or travel time, path length and population density. To calculate the length of the path, researchers used method of haversine formula. The value obtained from the calculation process is implemented on a web-based system. Some alternative paths and some of the closest shelters will be displayed in the system.

Pediatric issues in disaster management, Part 1: the emergency medical system and surge capacity.

PubMed

Mace, Sharon E; Sharieff, Ghazala; Bern, Andrew; Benjamin, Lee; Burbulys, Dave; Johnson, Ramon; Schreiber, Merritt

2010-01-01

Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients. The authors discuss key components of disaster planning and management for pediatric patients, including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs (SHCNs), mental health issues, and overcrowding/surge capacity. Specific policy recommendations and an appendix with detailed practical information and algorithms are included. The first part of this three-part series on pediatric issues in disaster management addresses the emergency medical system from the field to the hospital and surge capacity including the impact of crowding. The second part addresses the appropriate setup and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: children with SHCNs and mental health issues.

[The standardization of medical care and the training of medical personnel].

PubMed

Korbut, V B; Tyts, V V; Boĭshenko, V A

1997-09-01

The medical specialist training at all levels (medical orderly, doctor's assistant, general practitioner, doctors) should be based on the medical care standards. Preliminary studies in the field of military medicine standards have demonstrated that the medical service of the Armed Forces of Russia needs medical resources' standards, structure and organization standards, technology standards. Military medical service resources' standards should reflect the requisitions for: all medical specialists' qualification, equipment and material for medical set-ups, field medical systems, drugs, etc. Standards for structures and organization should include requisitions for: command and control systems in military formations' and task forces' medical services and their information support; health-care and evacuation functions, sanitary control and anti-epidemic measures and personnel health protection. Technology standards development could improve and regulate the health care procedures in the process of evacuation. Standards' development will help to solve the problem of the data-base for the military medicine education system and medical research.

Experimental proof of faster-is-slower in systems of frictional particles flowing through constrictions.

PubMed

Pastor, José M; Garcimartín, Angel; Gago, Paula A; Peralta, Juan P; Martín-Gómez, César; Ferrer, Luis M; Maza, Diego; Parisi, Daniel R; Pugnaloni, Luis A; Zuriguel, Iker

2015-12-01

The "faster-is-slower" (FIS) effect was first predicted by computer simulations of the egress of pedestrians through a narrow exit [D. Helbing, I. J. Farkas, and T. Vicsek, Nature (London) 407, 487 (2000)]. FIS refers to the finding that, under certain conditions, an excess of the individuals' vigor in the attempt to exit causes a decrease in the flow rate. In general, this effect is identified by the appearance of a minimum when plotting the total evacuation time of a crowd as a function of the pedestrian desired velocity. Here, we experimentally show that the FIS effect indeed occurs in three different systems of discrete particles flowing through a constriction: (a) humans evacuating a room, (b) a herd of sheep entering a barn, and (c) grains flowing out a 2D hopper over a vibrated incline. This finding suggests that FIS is a universal phenomenon for active matter passing through a narrowing.

Generating tsunami risk knowledge at community level as a base for planning and implementation of risk reduction strategies

NASA Astrophysics Data System (ADS)

Wegscheider, Stephanie; Post, Joachim; Mück, Matthias; Zosseder, Kai; Muhari, Abdul; Anwar, Herryal Z.; Gebert, Niklas; Strunz, Günter; Riedlinger, Torsten

2010-05-01

More than 4 million Indonesians live in tsunami-prone areas on the southern and western coasts of Sumatra, Java and Bali. Depending on the location of the tsunamigenic earthquake, in many cases the time to reach a tsunami-safe area is as short as 15 or 20 minutes. To increase the chances of a successful evacuation a comprehensive and thorough planning and preparation is necessary. For this purpose, detailed knowledge on potential hazard impact and safe areas, exposed elements such as people, critical facilities and lifelines, deficiencies in response capabilities and evacuation routes is crucial. The major aims of this paper are (i) to assess and quantify people's response capabilities and (ii) to identify high risk areas which have a high need of action to improve the response capabilities and thus to reduce the risk. The major factor influencing people's ability to evacuate successfully is the factor time. The estimated time of arrival of a tsunami at the coast which determines the overall available time for evacuation after triggering of a tsunami can be derived by analyzing modeled tsunami scenarios for a respective area. But in most cases, this available time frame is diminished by other time components including the time until natural or technical warning signs are received and the time until reaction follows a warning (understanding a warning and decision to take appropriate action). For the time to receive a warning we assume that the early warning centre is able to fulfil the Indonesian presidential decree to issue a warning within 5 minutes. Reaction time is difficult to quantify as here human intrinsic factors as educational level, believe, tsunami knowledge and experience play a role. Although we are aware of the great importance of this factor and the importance to minimize the reaction time, it is not considered in this paper. Quantifying the needed evacuation time is based on a GIS approach. This approach is relatively simple and enables local authorities to implement it at low technical complexity and relatively low cost and time needs. Basic principle is to define the best evacuation route from a given point to the nearest safe area. Here the fastest path from that point to the shelter location has to be found. Thereby the impact of land cover, slope, population density, population age and gender distribution are taken into account as literature studies prove these factors as highly important. Knowing the fastest path and the distance to the nearest safe area together with a spatially distributed pattern of evacuation speed delivers the time needed from each location to a shelter. A shelter location can either be a horizontal area or an evacuation building (vertical evacuation). For both kinds of evacuation target points, one limiting factor can be again time: are the people able to reach the target point within the available time? Especially for evacuation buildings, there is a second possibly limiting factor, namely capacity. In the majority of cases in all of the three study areas where this approach was applied to, capacity was the critical factor instead of time. Consequently, for planning purposes it is essential to know which area can be served by an evacuation building and which areas have to be assigned to a different evacuation target point due to exhausted capacity of the nearest one. The coverage of a building is also derived on basis of a GIS approach using the beforehand derived available and needed evacuation times and detailed population distribution data. Evacuation time and derived evacuable areas are then used to identify high risk areas. In combination with detailed population distribution data, hazard probability and hazard intensity, it is possible to identify areas with high risk and large deficiencies in response capabilities. Often enough, human response capabilities can be increased by thorough disaster planning and thus, the results of this paper provide valuable information for planning authorities to decrease the risk. This paper presents results exemplarily for the study area Kuta, Bali where we tested this approach and where it is also in progress to be implemented by local authorities.

The Fort McMurray, Alberta wildfires: Emergency and recovery management of healthcare services.

PubMed

Matear, David

2017-01-01

One of the largest wildfires in Canadian history raged through northern Alberta in May to July 2016, and prompted the largest emergency air evacuation in Canadian history. Central to the challenges were the evacuation of a regional hospital, and the emergency and recovery management associated with healthcare services. This paper describes multiple phases of emergency and recovery management, which employed and adapted the Incident Command System to healthcare services. There were no injuries reported throughout the medical evacuation and recovery of medical services. The leadership and management of healthcare services achieved the goals of evacuating patients and staff effectively, supporting emergency first responders and the re-entry of the population to Fort McMurray.

A computer simulation of aircraft evacuation with fire

NASA Technical Reports Server (NTRS)

Middleton, V. E.

1983-01-01

A computer simulation was developed to assess passenger survival during the post-crash evacuation of a transport category aircraft when fire is a major threat. The computer code, FIREVAC, computes individual passenger exit paths and times to exit, taking into account delays and congestion caused by the interaction among the passengers and changing cabin conditions. Simple models for the physiological effects of the toxic cabin atmosphere are included with provision for including more sophisticated models as they become available. Both wide-body and standard-body aircraft may be simulated. Passenger characteristics are assigned stochastically from experimentally derived distributions. Results of simulations of evacuation trials and hypothetical evacuations under fire conditions are presented.

Medical evacuations from oil rigs off the Gulf Coast of the United States from 2008 to 2012: reasons and cost implications.

PubMed

Thibodaux, Donald P; Bourgeois, Robert M; Loeppke, Ronald R; Konicki, Doris L; Hymel, Pamela A; Dreger, Marianne

2014-07-01

To identify reasons for air medical evacuations from oil rigs/platforms. Retrospective review of data of medical calls from 102 rigs/platforms in the US Gulf Coast from 2008 through 2012 with specific analysis of medevacs. On average, 1609 total calls per year relating to illness or injury on the 102 oil rigs/platforms with 4% to 7% requiring medical air evacuation. On average, 77% of medevacs were for nonoccupational medical injury or illness. Illness, not occupational injuries, is identified as the major reason for medical evacuations from oil rigs. Heart disease is the leading cause of chronic health conditions resulting in a medevac.

Biofeedback therapy for dyssynergic defecation

PubMed Central

Chiarioni, Giuseppe; Heymen, Steve; Whitehead, William E

2006-01-01

Dyssynergic defecation is one of the most common forms of functional constipation both in children and adults; it is defined by incomplete evacuation of fecal material from the rectum due to paradoxical contraction or failure to relax pelvic floor muscles when straining to defecate. This is believed to be a behavioral disorder because there are no associated morphological or neurological abnormalities, and consequently biofeedback training has been recommended for treatment. Biofeedback involves the use of pressure measurements or averaged electromyographic activity within the anal canal to teach patients how to relax pelvic floor muscles when straining to defecate. This is often combined with teaching the patient more appropriate techniques for straining (increasing intra-abdominal pressure) and having the patient practice defecating a water filled balloon. In adults, randomized controlled trials show that this form of biofeedback is more effective than laxatives, general muscle relaxation exercises (described as sham biofeedback), and drugs to relax skeletal muscles. Moreover, its effectiveness is specific to patients who have dyssynergic defecation and not slow transit constipation. However, in children, no clear superiority for biofeedback compared to laxatives has been demonstrated. Based on three randomized controlled studies in the last two years, biofeedback appears to be the preferred treatment for dyssynergic defecation in adults. PMID:17131466

Optimal control of diarrhea transmission in a flood evacuation zone

NASA Astrophysics Data System (ADS)

Erwina, N.; Aldila, D.; Soewono, E.

2014-03-01

Evacuation of residents and diarrhea disease outbreak in evacuation zone have become serious problem that frequently happened during flood periods. Limited clean water supply and infrastructure in evacuation zone contribute to a critical spread of diarrhea. Transmission of diarrhea disease can be reduced by controlling clean water supply and treating diarrhea patients properly. These treatments require significant amount of budget, which may not be fulfilled in the fields. In his paper, transmission of diarrhea disease in evacuation zone using SIRS model is presented as control optimum problem with clean water supply and rate of treated patients as input controls. Existence and stability of equilibrium points and sensitivity analysis are investigated analytically for constant input controls. Optimum clean water supply and rate of treatment are found using optimum control technique. Optimal results for transmission of diarrhea and the corresponding controls during the period of observation are simulated numerically. The optimum result shows that transmission of diarrhea disease can be controlled with proper combination of water supply and rate of treatment within allowable budget.

A numerical simulation strategy on occupant evacuation behaviors and casualty prediction in a building during earthquakes

NASA Astrophysics Data System (ADS)

Li, Shuang; Yu, Xiaohui; Zhang, Yanjuan; Zhai, Changhai

2018-01-01

Casualty prediction in a building during earthquakes benefits to implement the economic loss estimation in the performance-based earthquake engineering methodology. Although after-earthquake observations reveal that the evacuation has effects on the quantity of occupant casualties during earthquakes, few current studies consider occupant movements in the building in casualty prediction procedures. To bridge this knowledge gap, a numerical simulation method using refined cellular automata model is presented, which can describe various occupant dynamic behaviors and building dimensions. The simulation on the occupant evacuation is verified by a recorded evacuation process from a school classroom in real-life 2013 Ya'an earthquake in China. The occupant casualties in the building under earthquakes are evaluated by coupling the building collapse process simulation by finite element method, the occupant evacuation simulation, and the casualty occurrence criteria with time and space synchronization. A case study of casualty prediction in a building during an earthquake is provided to demonstrate the effect of occupant movements on casualty prediction.

Disaster Planning and Risk Communication With Vulnerable Communities: Lessons From Hurricane Katrina

PubMed Central

Eisenman, David P.; Cordasco, Kristina M.; Asch, Steve; Golden, Joya F.; Glik, Deborah

2007-01-01

Objectives. We studied the experience of Hurricane Katrina evacuees to better understand factors influencing evacuation decisions in impoverished, mainly minority communities that were most severely affected by the disaster. Methods. We performed qualitative interviews with 58 randomly selected evacuees living in Houston’s major evacuation centers from September 9 to 12, 2005. Transcripts were content analyzed using grounded theory methodology. Results. Participants were mainly African American, had low incomes, and were from New Orleans. Participants’ strong ties to extended family, friends, and community groups influenced other factors affecting evacuation, including transportation, access to shelter, and perception of evacuation messages. These social connections cut both ways, which facilitated and hindered evacuation decisions. Conclusions. Effective disaster plans must account for the specific obstacles encountered by vulnerable and minority communities. Removing the more apparent obstacles of shelter and transportation will likely be insufficient for improving disaster plans for impoverished, minority communities. The important influence of extended families and social networks demand better community-based communication and preparation strategies. PMID:17413069

Pathways toward a low cost evacuated collector system

NASA Astrophysics Data System (ADS)

Hull, J. R.; Schertz, W. W.; Allen, J. W.; Ogallagher, J. J.; Winston, R.

The goal of widespread use of solar thermal collectors will only be achieved when they are proven to be economically superior to competing energy sources. Evacuated tubular collectors appear to have the potential to achieve this goal. An advanced evacuated collector using nonimaging concentration under development at the University of Chicago and Argonne can achieve a 50% seasonal efficiency at heat delivery temperatures in excess of 170C. The same collector has an optical efficiency so that low temperature performance is also excellent. In this advanced collector design all of the critical components are enclosed in the vacuum, and the collector has an inherently long lifetime. The current cost of evacuated systems is too high, mainly because the volume of production has been too low to realize economies of mass production. It appears that certain design features of evacuated collectors can be changed (e.g., use of heat pipe absorbers) so as to introduce new system design and market strategy options that can reduce the balance of system cost.

Use of Subdural Evacuating Port System Following Open Craniotomy with Excision of Native Dura and Membranes for Management of Chronic Subdural Hematoma

PubMed Central

Bach, Ashley; McDermott, Michael W.

2017-01-01

An 86-year-old woman was admitted to the intensive care unit with a chronic subdural hematoma (CSDH) and rapid onset of worsening neurological symptoms. She was taken to the operating room for a mini-craniotomy for evacuation of the CSDH including excision of the dura and CSDH membrane. Postoperatively, a subdural evacuation port system (SEPS) was integrated into the craniotomy site and left in place rather than a traditional subdural catheter drain to evacuate the subdural space postoperatively. The patient had a good recovery and improvement of symptoms after evacuation and remained clinically well after the SEPS was removed. We offer the technique of dura and CSDH membrane excision plus SEPS drain as an effective postoperative alternative to the standard craniotomy leaving the native dura intact with traditional subdural drain that overlies the cortical surface of the brain in treating patients with CSDH. PMID:28560123

Spatial and temporal variation in evacuee risk perception throughout the evacuation and return-entry process.

PubMed

Siebeneck, Laura K; Cova, Thomas J

2012-09-01

Developing effective evacuation and return-entry plans requires understanding the spatial and temporal dimensions of risk perception experienced by evacuees throughout a disaster event. Using data gathered from the 2008 Cedar Rapids, Iowa Flood, this article explores how risk perception and location influence evacuee behavior during the evacuation and return-entry process. Three themes are discussed: (1) the spatial and temporal characteristics of risk perception throughout the evacuation and return-entry process, (2) the relationship between risk perception and household compliance with return-entry orders, and (3) the role social influences have on the timing of the return by households. The results indicate that geographic location and spatial variation of risk influenced household risk perception and compliance with return-entry plans. In addition, sociodemographic characteristics influenced the timing and characteristics of the return groups. The findings of this study advance knowledge of evacuee behavior throughout a disaster and can inform strategies used by emergency managers throughout the evacuation and return-entry process. © 2012 Society for Risk Analysis.

The World Trade Center bombing: injury prevention strategies for high-rise building fires.

PubMed

Quenemoen, L E; Davis, Y M; Malilay, J; Sinks, T; Noji, E K; Klitzman, S

1996-06-01

The WTC disaster provided an opportunity to look for ways to prevent morbidity among occupants of high-rise buildings during fires. This paper first describes the overall morbidity resulting from the explosion and fire, and second, presents the results of a case-control study carried out to identify risk factors for smoke-related morbidity. The main ones include: increased age, presence of a pre-existing cardio-pulmonary condition, entrapment in a lift and prolonged evacuation time. Study results point to the importance of the following safety systems during high-rise building fires: smoke-control systems with separate emergency power sources; lift-cars, lift-car position-monitoring systems, and lift-car communication systems with separate emergency power sources; two-way emergency communication systems on all floors and in stairwells; stairwells with emergency lighting and designed for the rapid egress of crowds; evacuation systems/equipment to assist in the evacuation of vulnerable people (elderly, infirm). Also important are evacuation plans that include regularly scheduled safety training and evacuation drills.

Improving the Emergency Manager’s Hurricane Evacuation Decision Making Through Serious Gaming

DTIC Science & Technology

2016-06-17

Serious Gaming Hayley J. Davison Reynolds, Maxwell H. Perlman Darren P. Wilson MIT Lincoln Laboratory DHS Science and Technology Directorate...transfer it to an actual evacuation event. Through this work, a web-based, ‘serious gaming ’ approach was used to develop hurricane evacuation decision...training for the emergency manager. This paper describes the iterative design approach to developing a training game and collect initial feedback

Casualty Evacuation Delay and Outcomes

DTIC Science & Technology

2003-01-01

consequences of delay in therapy on wounded individuals. The contractor was charged with studying the effect of delay on evacuation on outcome of...process. 3 There are a remarkably small proportion of patient diagnoses and states in which time has an effect on outcome . This is because the vast...emphasis on estimating the effect of delayed evacuation on injury outcome and means to mitigating such effects . Since some of the Specific Aims were

An example of extreme cardiology: chest pain on the high seas and helicoptered medical evacuations: the French Navy experience.

PubMed

Vinsonneau, Ulric; Cavel, Christiane; Bombert, Christophe; Lely, Laurent; Paleiron, Nicolas; Vergez-Larrouget, Claude; Cornily, Jean-Christophe; Castellant, Philippe; Gilard, Martine; Paule, Paule; Bronstein, Jean-Ariel

2012-10-01

Medicalized high sea rescue is very different from prehospital medical evacuation. It requires specifically trained medical teams because the difficulties are marine, aerial, and medically related. The French Navy provides medical evacuations by helicopter on the Atlantic coast, up to 320 km offshore and under all weather conditions. The epidemiology of acute chest pain in the high seas has been poorly described. Therefore, in this retrospective study, we aimed to assess the prevalence and constraints found in the management of these emergencies. From January 1, 2000, to April 30, 2009, 286 medical evacuations by helicopter were performed, 132 of which were due to traumatological emergencies, and 154 to medical emergencies. Acute chest pain, with 36 missions, was the leading cause of medical evacuation. All evacuated patients were men who were either professional sailors or ferry passengers. The median age was 48 years (range, 26-79). The most common prehospital diagnosis was coronary chest pain in 23 patients (64%), including 11 patients with acute coronary syndrome with ST-segment elevation. Thirty-two patients were airlifted by helicopter. All patients benefited from monitoring, electrocardiogram, peripheral venous catheter, and medical management as soon as the technical conditions allowed it. Copyright © 2012 Elsevier Inc. All rights reserved.

Aeromedical evacuation using an aircraft transit isolator of a patient with Lassa fever.

PubMed

Lotz, Eric; Raffin, Hervé

2012-05-01

Lassa fever is a viral hemorrhagic fever only present in West Africa. The mortality rate is 1% and may reach 15% among hospitalized patients. Transmission between humans is mostly due to direct contact with infected body fluids. Aeromedical evacuation of patients with viral hemorrhagic fevers (such as Lassa fever) demands strict isolation measures. Only a few cases of such evacuations have been reported in the literature during the last 40 yr. The use of an aircraft transit isolator device could be helpful. We report the aeromedical evacuation of a confirmed Lassa fever patient from Sierra Leone to Sweden with a dedicated air ambulance using an aircraft transit isolator. The patient was a 30-yr-old physician working for a nonprofit organization. The patient contracted the disease working with infected hospitalized patients. The duration of the mission between activation and arrival at the Swedish hospital was 36 h, which is within the World Health Organization recommendations. Evacuation of patients with potentially lethal contagious infections is possible, but only with strict isolation measures. Specific protective equipment and isolator are mandatory. Medical and technical crews performing such evacuations should be trained in proper equipment use and the isolator should first be used with a low-risk patient to create minimal risk transport conditions.

Facilitating emergency hospital evacuation through uniform discharge criteria.

PubMed

Sandra, Keret; Meital, Nahari; Ofer, Merin; Limor, Aharonson-Daniel; Sara, Goldberg; Bruria, Adini

2017-05-01

Though hospitals' operational continuity is crucial, full institutional evacuation may at times be unavoidable. The study's objective was to establish criteria for discharge of patients during complete emergency evacuation and compare scope of patients suitable for discharge pre/post implementation of criteria. Standards for patient discharge during an evacuation were developed based on literature and disaster managers. The standards were reviewed in a two-round Delphi process. All hospitals in Israel were requested to identify inpatients' that could be released home during institutional evacuation. Potential discharges were compared in 2013-2014, before and after formulation of discharge criteria. Consensus exceeding 80% was obtained for four out of five criteria after two Delphi cycles. Average projected discharge rate before and after formulation of criteria was 34.2% and 42.9%, respectively (p<0.001). Variance in potential dischargeable patients was 31-fold less in 2014 than in 2013 (MST=8,452 versus MST=264,366, respectively; p<0.001). Differences were found between small, medium and large hospitals in mean rate of dischargeable patients: 52.1%, 41.5% and 42.2%, respectively (p=0.001). The study's findings enable to forecast the extent of patients that may be released home during full emergency evacuation of a hospital; thereby facilitating preparedness of contingency plans. Copyright © 2016 Elsevier Inc. All rights reserved.

Complementary methods to plan pedestrian evacuation of the French Riviera's beaches in case of tsunami threat: graph- and multi-agent-based modelling

NASA Astrophysics Data System (ADS)

Sahal, A.; Leone, F.; Péroche, M.

2013-07-01

Small amplitude tsunamis have impacted the French Mediterranean shore (French Riviera) in the past centuries. Some caused casualties; others only generated economic losses. While the North Atlantic and Mediterranean tsunami warning system is being tested and is almost operational, no awareness and preparedness measure is being implemented at a local scale. Evacuation is to be considered along the French Riviera, but no plan exists within communities. We show that various approaches can provide local stakeholders with evacuation capacities assessments to develop adapted evacuation plans through the case study of the Cannes-Antibes region. The complementarity between large- and small-scale approaches is demonstrated with the use of macro-simulators (graph-based) and micro-simulators (multi-agent-based) to select shelter points and choose evacuation routes for pedestrians located on the beach. The first one allows automatically selecting shelter points and measuring and mapping their accessibility. The second one shows potential congestion issues during pedestrian evacuations, and provides leads for the improvement of urban environment. Temporal accessibility to shelters is compared to potential local and distal tsunami travel times, showing a 40 min deficit for an adequate crisis management in the first scenario, and a 30 min surplus for the second one.

Comparison of techniques for transdiaphragmatic thoracic drainage after diaphragmatic defect closure in dogs: a cadaveric study

PubMed Central

Yoon, Hun-Young; Mann, F. A.; Lee, Suhwon

2013-01-01

Four thoracic evacuation techniques for pneumothorax elimination after diaphragmatic defect closure were compared in 40 canine cadavers. After creating a defect in the left side of the diaphragm, thoracic drainage was performed by thoracostomy tube insertion through the defect and a small (DD-SP) or large (DD-LP) puncture created in the caudal mediastinum, or through both the diaphragmatic defect and intact contralateral diaphragm with a small (DI-SP) or large (DI-LP) puncture in made in the caudal mediastinum. Differences in intrapleural pressure (IPP) between the right and left hemithoraxes after air evacuation along with differences in IPP before making a defect and after air evacuation in each hemithorax were calculated. A difference (p ≤ 0.0011) in IPP between the left and right hemithoraxes after air evacuation as well as before making a defect and after air evacuation in the right hemithorax was detected for the DD-SP group. No significant differences (p ≥ 0.0835) were observed for the DI-LP, DD-LP, or DI-SP groups. Creation of a large mediastinal puncture or thoracic evacuation through both a diaphragmatic defect and intact contralateral diaphragm can facilitate proper pneumothorax elimination bilaterally after diaphragmatic defect closure in dogs with a small puncture in the caudal mediastinum. PMID:23814472

The Effects of Evacuation on Nursing Home Residents With Dementia

PubMed Central

Brown, Lisa M.; Dosa, David M.; Thomas, Kali; Hyer, Kathryn; Feng, Zhanlian; Mor, Vincent

2013-01-01

Background In response to the hurricane-related deaths of nursing home residents, there has been a steady increase in the number of facilities that evacuate under storm threat. This study examined the effects of evacuation during Hurricane Gustav on residents who were cognitively impaired. Methods Nursing homes in counties located in the path of Hurricane Gustav were identified. The Minimum Data Set resident assessment files were merged with the Centers for Medicare enrollment file to determine date of death for residents in identified facilities. Difference-in-differences analyses were conducted adjusting for residents’ demographic characteristics and acuity. Results The dataset included 21,255 residents living in 119 at risk nursing homes over three years of observation. Relative to the two years before the storm, there was a 2.8 percent increase in death at 30 days and a 3.9 percent increase in death at 90 days for residents with severe dementia who evacuated for Hurricane Gustav, controlling for resident demographics and acuity. Conclusions The findings of this research reveal the deleterious effects of evacuation on residents with severe dementia. Interventions need to be developed and tested to determine the best methods for protecting this at risk population when there are no other options than to evacuate the facility. PMID:22930698

Utilization of telemedicine in the U.S. military in a deployed setting.

PubMed

Hwang, Jane S; Lappan, Charles M; Sperling, Leonard C; Meyerle, Jon H

2014-11-01

A retrospective evaluation of the Department of Defense teledermatology consultation program from 2004 to 2012 was performed, focusing on clinical application and outcome measures such as consult volume, response time, and medical evacuation status. A retrospective review of the teledermatology program between 2004 and 2012 was evaluated based on defined outcome measures. In addition, 658 teledermatology cases were reviewed to assess how the program was utilized by health care providers from 2011 to 2012. As high as 98% of the teledermatology consults were answered within 24 hours, and 23% of consults within 1 hour. The most common final diagnoses included eczematous dermatitis, contact dermatitis, and evaluation for nonmelanoma skin cancer. The most common medications recommended included topical corticosteroids, oral antibiotics, antihistamines, and emollients. Biopsy was most commonly recommended for further evaluation. Following teleconsultation, 46 dermatologic evacuations were "avoided" as the patient was not evacuated based on the consultants' recommendation. Consultants' recommendations to the referring provider "facilitated" 41 evacuations. Telemedicine in the U.S. military has provided valuable dermatology support to providers in remote locations by delivering appropriate and timely consultation for military service members and coalition partners. In addition to avoiding unnecessary medical evacuations, the program facilitated appropriate evacuations that may otherwise have been delayed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Quantitative comparison between crowd models for evacuation planning and evaluation

NASA Astrophysics Data System (ADS)

Viswanathan, Vaisagh; Lee, Chong Eu; Lees, Michael Harold; Cheong, Siew Ann; Sloot, Peter M. A.

2014-02-01

Crowd simulation is rapidly becoming a standard tool for evacuation planning and evaluation. However, the many crowd models in the literature are structurally different, and few have been rigorously calibrated against real-world egress data, especially in emergency situations. In this paper we describe a procedure to quantitatively compare different crowd models or between models and real-world data. We simulated three models: (1) the lattice gas model, (2) the social force model, and (3) the RVO2 model, and obtained the distributions of six observables: (1) evacuation time, (2) zoned evacuation time, (3) passage density, (4) total distance traveled, (5) inconvenience, and (6) flow rate. We then used the DISTATIS procedure to compute the compromise matrix of statistical distances between the three models. Projecting the three models onto the first two principal components of the compromise matrix, we find the lattice gas and RVO2 models are similar in terms of the evacuation time, passage density, and flow rates, whereas the social force and RVO2 models are similar in terms of the total distance traveled. Most importantly, we find that the zoned evacuation times of the three models to be very different from each other. Thus we propose to use this variable, if it can be measured, as the key test between different models, and also between models and the real world. Finally, we compared the model flow rates against the flow rate of an emergency evacuation during the May 2008 Sichuan earthquake, and found the social force model agrees best with this real data.

Novel device and technique for minimally invasive intracerebral hematoma evacuation in the same setting of a ruptured intracranial aneurysm: combined treatment in the neurointerventional angiography suite.

PubMed

Turner, Raymond D; Vargas, Jan; Turk, Aquilla S; Chaudry, M Imran; Spiotta, Alejandro M

2015-03-01

The presence of intracerebral hematoma from aneurysm rupture is an indication for craniotomy for clot evacuation and aneurysm clipping. Some centers have begun securing aneurysms with coil embolization followed by clot evacuation in the operating room. This approach requires transporting a patient from the angiography suite to the operating room, which can take valuable time and resources. To report our experience with 3 cases in which a novel technique for minimally invasive evacuation of intracerebral hematomas after endovascular treatment of ruptured intracranial aneurysms was used. The Penumbra Apollo system can be used in the angiography suite in conjunction with neuroendovascular techniques to simultaneously address a symptomatic hematoma associated with a ruptured aneurysm. Standard preoperative computed tomography angiography was performed on arrival to the emergency department. The patients underwent diagnostic cerebral angiography followed by balloon-assisted coil embolization and then remained in the neurointerventional suite for intracerebral hematoma evacuation with the Apollo system. All patients tolerated coil embolization and hematoma evacuation well. The combined procedures lasted <3 hours in both cases. Two patients were eventually discharged to acute rehabilitation facilities less than a month after their initial insult, and 1 has been cleared to return to work. The other patient was transferred to hospice care. The Apollo aspiration system appears to be a safe and effective minimally invasive option for intracerebral hematoma evacuation, particularly when coupled with endovascular embolization of ruptured intracranial aneurysms. Future work will address which patient population is most likely to benefit from this promising technique.

Spatiotemporal Identification of Potential Tsunami Vertical Evacuation Sites: A Case Study of Shizuoka City, Japan.

PubMed

Voulgaris, Gerasimos; Aleksejeva, Jelena

2017-04-24

The city of Shizuoka directly faces the Nankai Trough (known for its tsunamigenic history), and is facing a potential tsunami threat. In this setting vertical evacuation can be of great significance in reducing loss of life. We apply a GIS based method in order to identify sites that could be utilized for vertical evacuation within the existing building stock of the city, under two tsunami scenarios of 5 and 10 meters of run-up. For each building, we estimate the volume that is expected to be lost per scenario, as well as the number of people inside and how that number fluctuates over different times of the day. Using the criteria of 25% or less building volume loss and 6 cubic meters of volume per person, resulted in 2,046 potential sites for the 10 meter scenario and 1,643 potential sites for the 5 meter scenario, with the maximum amount of people that can potentially be accepted in these sites in the morning hours being 873,537 in the 10 meter scenario and 304,734 in the 5 meter scenario. Our approach has shown that there is a temporal aspect in tsunami vertical evacuation due to the movement of the local population throughout the day. the proposed method can be used for preliminary identification of potential vertical evacuation sites, however, it must be followed by further vulnerability and engineering assessments of buildings, in combination with accessibility and evacuation routing in order to reach a viable and complete evacuation plan.

Spatiotemporal Identification of Potential Tsunami Vertical Evacuation Sites: A Case Study of Shizuoka City, Japan

PubMed Central

Voulgaris, Gerasimos; Aleksejeva, Jelena

2017-01-01

Introduction: The city of Shizuoka directly faces the Nankai Trough (known for its tsunamigenic history), and is facing a potential tsunami threat. In this setting vertical evacuation can be of great significance in reducing loss of life. Methods: We apply a GIS based method in order to identify sites that could be utilized for vertical evacuation within the existing building stock of the city, under two tsunami scenarios of 5 and 10 meters of run-up. For each building, we estimate the volume that is expected to be lost per scenario, as well as the number of people inside and how that number fluctuates over different times of the day. Results: Using the criteria of 25% or less building volume loss and 6 cubic meters of volume per person, resulted in 2,046 potential sites for the 10 meter scenario and 1,643 potential sites for the 5 meter scenario, with the maximum amount of people that can potentially be accepted in these sites in the morning hours being 873,537 in the 10 meter scenario and 304,734 in the 5 meter scenario. Discussion: Our approach has shown that there is a temporal aspect in tsunami vertical evacuation due to the movement of the local population throughout the day. the proposed method can be used for preliminary identification of potential vertical evacuation sites, however, it must be followed by further vulnerability and engineering assessments of buildings, in combination with accessibility and evacuation routing in order to reach a viable and complete evacuation plan. PMID:28736680

Demographic transition and factors associated with remaining in place after the 2011 Fukushima nuclear disaster and related evacuation orders.

PubMed

Morita, Tomohiro; Nomura, Shuhei; Furutani, Tomoyuki; Leppold, Claire; Tsubokura, Masaharu; Ozaki, Akihiko; Ochi, Sae; Kami, Masahiro; Kato, Shigeaki; Oikawa, Tomoyoshi

2018-01-01

Demographic changes as a result of evacuation in the acute phase of the 2011 Fukushima nuclear disaster are not well evaluated. We estimated post-disaster demographic transitions in Minamisoma City-located 14-38 km north of the nuclear plant-in the first month of the disaster; and identified demographic factors associated with the population remaining in the affected areas. We extracted data from the evacuation behavior survey administered to participants in the city between July 11, 2011 and April 30, 2013. Using mathematical models, we estimated the total population in the city after the disaster according to sex, age group, and administrative divisions of the city. To investigate factors associated with the population remaining in place after the disaster, a probit regression model was employed, taking into account sex, age, pre-disaster dwelling area, and household composition. The overall population decline in Minamisoma City peaked 11 days after the disaster, when the population reached 7,107 people-11% of the pre-disaster level. The remaining population levels differed by area: 1.1% for mandatory evacuation zone, 12.5% for indoor sheltering zone, and 12.6% for other areas of the city. Based on multiple regression analyses, higher odds for remaining in place were observed among men (odds ratio 1.72 [95% confidence intervals 1.64-1.85]) than women; among people aged 40-64 years (1.40 [1.24-1.58]) than those aged 75 years or older; and among those living with the elderly, aged 70 years or older (1.18 [1.09-1.27]) or those living alone (1.71 [1.50-1.94]) than among those who were not. Despite the evacuation order, some residents of mandatory evacuation zones remained in place, signaling the need for preparation to respond to their post-disaster needs. Indoor sheltering instructions may have accelerated voluntary evacuation, and this demonstrates the need for preventing potentially disorganized evacuation in future nuclear events.

The FASTER Approach: A New Tool for Calculating Real-Time Tsunami Flood Hazards

NASA Astrophysics Data System (ADS)

Wilson, R. I.; Cross, A.; Johnson, L.; Miller, K.; Nicolini, T.; Whitmore, P.

2014-12-01

In the aftermath of the 2010 Chile and 2011 Japan tsunamis that struck the California coastline, emergency managers requested that the state tsunami program provide more detailed information about the flood potential of distant-source tsunamis well ahead of their arrival time. The main issue is that existing tsunami evacuation plans call for evacuation of the predetermined "worst-case" tsunami evacuation zone (typically at a 30- to 50-foot elevation) during any "Warning" level event; the alternative is to not call an evacuation at all. A solution to provide more detailed information for secondary evacuation zones has been the development of tsunami evacuation "playbooks" to plan for tsunami scenarios of various sizes and source locations. To determine a recommended level of evacuation during a distant-source tsunami, an analytical tool has been developed called the "FASTER" approach, an acronym for factors that influence the tsunami flood hazard for a community: Forecast Amplitude, Storm, Tides, Error in forecast, and the Run-up potential. Within the first couple hours after a tsunami is generated, the National Tsunami Warning Center provides tsunami forecast amplitudes and arrival times for approximately 60 coastal locations in California. At the same time, the regional NOAA Weather Forecast Offices in the state calculate the forecasted coastal storm and tidal conditions that will influence tsunami flooding. Providing added conservatism in calculating tsunami flood potential, we include an error factor of 30% for the forecast amplitude, which is based on observed forecast errors during recent events, and a site specific run-up factor which is calculated from the existing state tsunami modeling database. The factors are added together into a cumulative FASTER flood potential value for the first five hours of tsunami activity and used to select the appropriate tsunami phase evacuation "playbook" which is provided to each coastal community shortly after the forecast is provided.

Quantifying human response capabilities towards tsunami threats at community level

NASA Astrophysics Data System (ADS)

Post, J.; Mück, M.; Zosseder, K.; Wegscheider, S.; Taubenböck, H.; Strunz, G.; Muhari, A.; Anwar, H. Z.; Birkmann, J.; Gebert, N.

2009-04-01

Decision makers at the community level need detailed information on tsunami risks in their area. Knowledge on potential hazard impact, exposed elements such as people, critical facilities and lifelines, people's coping capacity and recovery potential are crucial to plan precautionary measures for adaptation and to mitigate potential impacts of tsunamis on society and the environment. A crucial point within a people-centred tsunami risk assessment is to quantify the human response capabilities towards tsunami threats. Based on this quantification and spatial representation in maps tsunami affected and safe areas, difficult-to-evacuate areas, evacuation target points and evacuation routes can be assigned and used as an important contribution to e.g. community level evacuation planning. Major component in the quantification of human response capabilities towards tsunami impacts is the factor time. The human response capabilities depend on the estimated time of arrival (ETA) of a tsunami, the time until technical or natural warning signs (ToNW) can be received, the reaction time (RT) of the population (human understanding of a tsunami warning and the decision to take appropriate action), the evacuation time (ET, time people need to reach a safe area) and the actual available response time (RsT = ETA - ToNW - RT). If RsT is larger than ET, people in the respective areas are able to reach a safe area and rescue themselves. Critical areas possess RsT values equal or even smaller ET and hence people whin these areas will be directly affected by a tsunami. Quantifying the factor time is challenging and an attempt to this is presented here. The ETA can be derived by analyzing pre-computed tsunami scenarios for a respective area. For ToNW we assume that the early warning center is able to fulfil the Indonesian presidential decree to issue a warning within 5 minutes. RT is difficult as here human intrinsic factors as educational level, believe, tsunami knowledge and experience besides others play a role. An attempt to quantify this variable under high uncertainty is also presented. Quantifying ET is based on a GIS modelling using a Cost Weighted Distance approach. Basic principle is to define the best evacuation path from a given point to the next safe area (shelter location). Here the fastest path from that point to the shelter location has to be found. Thereby the impact of land cover, slope, population density, population age and gender distribution are taken into account as literature studies prove these factors as highly important. Knowing the fastest path and the distance to the next safe area together with a spatially distributed pattern of evacuation speed delivers the time needed from each location to a safe area. By considering now the obtained time value for RsT the coverage area of an evacuation target point (safe area) can be assigned. Incorporating knowledge on people capacity of an evacuation target point the respective coverage area is refined. Hence areas with weak, moderate and good human response capabilities can be detected. This allows calculation of potential amount of people affected (dead or injured) and amount of people dislocated. First results for Kuta (Bali) for a worst case tsunami event deliver people affected of approx. 25 000 when RT = 0 minutes (direct evacuation when receiving a tsunami warning to 120 000 when RT > ETA (no evacuation action until tsunami hits the land). Additionally fastest evacuation routes to the evacuation target points can be assigned. Areas with weak response capabilities can be assigned as priority areas to install e.g. additional evacuation target points or to increase tsunami knowledge and awareness to promote a faster reaction time. Especially in analyzing underlying socio-economic properties causing deficiencies in responding to a tsunami threat can lead to valuable information and direct planning of adaptation measures. Keywords: Community level, Risk and vulnerability assessment, Early warning, Disaster management, Tsunami, Indonesia

Role of positive urethrovesical feedback in vesical evacuation. The concept of a second micturition reflex: the urethrovesical reflex.

PubMed

Shafik, Ahmed; Shafik, Ali A; El-Sibai, Olfat; Ahmed, Ismail

2003-08-01

Upon feeling the urge to urinate, the urinary bladder contracts, the urethral sphincters relax and urine flows through the urethra. These actions are mediated by the micturition reflex. We investigated the hypothesis that vesical contraction is maintained by positive feedback through continuous flow of urine through the urethra, and that the cessation of urine flow aborts detrusor contraction. Normal saline was infused into the urinary bladders of 17 healthy volunteers (age 35.2 years+/-4.2(SD); ten women and seven men) at a rate of 100 ml/min. On urge, which occurred at a mean volume of 408.6 ml+/-28.7 of saline, the subject micturated while the vesical and urethral pressures during voiding were being recorded; residual urine was measured. The test was repeated after anesthetizing the urethra with xylocaine gel or, on another occasion, after applying a bland gel. On micturition, the urine was evacuated as a continuous stream without straining; no residual fluid was collected. After urethral anesthetization, the fluid came out of the urethra in multiple intermittent spurts and only with excessive straining. There was a large amount of residual fluid (184.6 ml+/-28.4). The results of bland gel application showed no significant difference ( P>0.05) from those without gel. Detrusor contraction during micturition is suggested to be maintained by positive urethrovesical feedback elicited by the continued passage of urine through the urethra. This feedback seems to be effected through the urethrovesical reflex, which produces vesical contraction on stimulation of the urethral stretch receptors. Abortion of this reflex by urethral anesthetization resulted in failure of detrusor contraction and excessive straining was needed to achieve bladder evacuation in multiple spurts. The urethrovesical reflex is thus assumed to constitute a second micturition reflex responsible for the continuation of detrusor contraction and urination. The role of this reflex in the pathogenesis of micturition disorders needs to be studied.

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

DTIC Science & Technology

2014-02-01

Chamber construction has been completed and swine experiments have been initiated. The NMRC Center for Hypobaric Experimentation, Simulation and...Aeromedical evacuation, en-route care, hypobaric conditions, hypobaric chamber, swine model 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...diminished morbidity and mortality among combat casualties. However, not much is known about the effects of long range aero-medical evacuation in hypobaric

The Bali bombing: civilian aeromedical evacuation.

PubMed

Tran, Minh D; Garner, Alan A; Morrison, Ion; Sharley, Peter H; Griggs, William M; Xavier, Colin

2003-10-06

After the Bali bombing on 12 October 2002, many injured Australians required evacuation to Darwin, and then to burns units around Australia. Many patients were evacuated from Denpasar by Qantas, with assistance from staff of civilian medical retrieval services. The transport of patients from Darwin to specialist burns units involved a coordinated response of civilian and military services. Some issues in responding to such disasters were identified, and a national coordinating network could improve future responses.

Hypothermia for Patients Requiring Evacuation of Subdural Hematoma: Effect on Spreading Depolarizations

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-16-C-0161 TITLE: Hypothermia for Patients Requiring Evacuation of Subdural Hematoma: Effect on Spreading Depolarizations...4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-16-C-0161 Hypothermia for Patients Requiring Evacuation of Subdural Hematoma: Effect on Spreading...in a sub-study of the HOPES trial to assess the effects of hypothermia on the pathologic mechanism of spreading depolarizations (SD). HOPES is a

Educating the Communists of the Future: Notes on the Educational Life of the Spanish Children Evacuated to the USSR during the Spanish Civil War

ERIC Educational Resources Information Center

Sierra Blas, Verónica

2015-01-01

The high rate of child mortality registered during the early months of the Civil War led the Republican authorities to initiate several operations to evacuate youngsters with the purpose of protecting and saving the children of Spain. At the beginning, the children were evacuated to zones in the interior of the country far removed from the front…

Two occurrences of delayed epidural hematoma in different areas following decompressive craniectomy for acute subdural hematoma in a single patient: a case report.

PubMed

Wu, Ruhong; Shi, Jia; Cao, Jiachao; Mao, Yumin; Dong, Bo

2017-12-04

Delayed epidural hematoma (DEH) following evacuation of traumatic acute subdural hematoma (ASDH) or acute epidural hematoma (EDH) is a rare but devastating complication, especially when it occurs sequentially in a single patient. A 19-year-old man who developed contralateral DEH following craniotomy for evacuation of a traumatic right-side ASDH and then developed a left-side DEH of the posterior cranial fossa after craniotomy for evacuation of the contralateral DEH. He was immediately returned to the operating room for additional surgeries and his neurological outcome was satisfactory. Although DEH occurring after evacuation of ASDH or acute EDH is a rare event, timely recognition is critical to prognosis.

A cellular automaton model for evacuation flow using game theory

NASA Astrophysics Data System (ADS)

Guan, Junbiao; Wang, Kaihua; Chen, Fangyue

2016-11-01

Game theory serves as a good tool to explore crowd dynamic conflicts during evacuation processes. The purpose of this study is to simulate the complicated interaction behavior among the conflicting pedestrians in an evacuation flow. Two types of pedestrians, namely, defectors and cooperators, are considered, and two important factors including fear index and cost coefficient are taken into account. By combining the snowdrift game theory with a cellular automaton (CA) model, it is shown that the increase of fear index and cost coefficient will lengthen the evacuation time, which is more apparent for large values of cost coefficient. Meanwhile, it is found that the defectors to cooperators ratio could always tend to consistent states despite different values of parameters, largely owing to self-organization effects.

The role of integrating natural and social science concepts for risk governance and the design of people-centred early warning systems. Case study from the German-Indonesian Tsunami Early Warning System Project (GITEWS)

NASA Astrophysics Data System (ADS)

Gebert, Niklas; Post, Joachim

2010-05-01

The development of early warning systems are one of the key domains of adaptation to global environmental change and contribute very much to the development of societal reaction and adaptive capacities to deal with extreme events. Especially, Indonesia is highly exposed to tsunami. In average every three years small and medium size tsunamis occur in the region causing damage and death. In the aftermath of the Indian Ocean Tsunami 2004, the German and Indonesian government agreed on a joint cooperation to develop a People Centered End-to-End Early Warning System (GITEWS). The analysis of risk and vulnerability, as an important step in risk (and early warning) governance, is a precondition for the design of effective early warning structures by delivering the knowledge base for developing institutionalized quick response mechanisms of organizations involved in the issuing of a tsunami warning, and of populations exposed to react to warnings and to manage evacuation before the first tsunami wave hits. Thus, a special challenge for developing countries is the governance of complex cross-sectoral and cross-scale institutional, social and spatial processes and requirements for the conceptualization, implementation and optimization of a people centered tsunami early warning system. In support of this, the risk and vulnerability assessment of the case study aims at identifying those factors that constitute the causal structure of the (dis)functionality between the technological warning and the social response system causing loss of life during an emergency situation: Which social groups are likely to be less able to receive and respond to an early warning alert? And, are people able to evacuate in due time? Here, only an interdisciplinary research approach is capable to analyze the socio-spatial and environmental conditions of vulnerability and risk and to produce valuable results for decision makers and civil society to manage tsunami risk in the early warning context. This requires the integration of natural / spatial and social science concepts, methods and data: E.g. a scenario based approach for tsunami inundation modeling was developed to provide decision makers with options to decide up to what level they aim to protect their people and territory, on the contrary household surveys were conducted for the spatial analysis of the evacuation preparedness of the population as a function of place specific hazard, risk, warning and evacuation perception; remote sensing was applied for the spatial analysis (land-use) of the socio-physical conditions of a city and region for evacuation; and existing social / population statistics were combined with land-use data for the precise spatial mapping of the population exposed to tsunami risks. Only by utilizing such a comprehensive assessment approach valuable information for risk governance can be generated. The results are mapped using GIS and designed according to the specific needs of different end-users, such as public authorities involved in the design of warning dissemination strategies, land-use planners (shelter planning, road network configuration) and NGOs mandated to provide education for the general public on tsunami risk and evacuation behavior. The case study of the city of Padang (one of the pilot areas of GITEWS), Indonesia clearly show, that only by intersecting social (vulnerability) and natural hazards research a comprehensive picture on tsunami risk can be provided with which risk governance in the early warning context can be conducted in a comprehensive, systemic and sustainable manner.

Agent-based evacuation simulation for spatial allocation assessment of urban shelters

NASA Astrophysics Data System (ADS)

Yu, Jia; Wen, Jiahong; Jiang, Yong

2015-12-01

The construction of urban shelters is one of the most important work in urban planning and disaster prevention. The spatial allocation assessment is a fundamental pre-step for spatial location-allocation of urban shelters. This paper introduces a new method which makes use of agent-based technology to implement evacuation simulation so as to conduct dynamic spatial allocation assessment of urban shelters. The method can not only accomplish traditional geospatial evaluation for urban shelters, but also simulate the evacuation process of the residents to shelters. The advantage of utilizing this method lies into three aspects: (1) the evacuation time of each citizen from a residential building to the shelter can be estimated more reasonably; (2) the total evacuation time of all the residents in a region is able to be obtained; (3) the road congestions in evacuation in sheltering can be detected so as to take precautionary measures to prevent potential risks. In this study, three types of agents are designed: shelter agents, government agents and resident agents. Shelter agents select specified land uses as shelter candidates for different disasters. Government agents delimitate the service area of each shelter, in other words, regulate which shelter a person should take, in accordance with the administrative boundaries and road distance between the person's position and the location of the shelter. Resident agents have a series of attributes, such as ages, positions, walking speeds, and so on. They also have several behaviors, such as reducing speed when walking in the crowd, helping old people and children, and so on. Integrating these three types of agents which are correlated with each other, evacuation procedures can be simulated and dynamic allocation assessment of shelters will be achieved. A case study in Jing'an District, Shanghai, China, was conducted to demonstrate the feasibility of the method. A scenario of earthquake disaster which occurs in nighttime was set to simulate the evacuation process of the residents to the earthquake shelter candidates in the study area. The simulation results convinced that the proposed method can better evaluate the spatial configuration of urban shelter than traditional GIS methods. The method can help local decision-makers preferably handle shelter planning and emergency evacuation management problems. It can also be extended to conduct similar assessment work in other urban regions for different kinds of shelters.

PSTD, major depressive symptoms, and substance abuse following September 11, 2001, in a midwestern university population.

PubMed

Cardenas, Jessica; Williams, Kimberly; Wilson, John P; Fanouraki, Gianna; Singh, Arvin

2003-01-01

This research investigated the prevalence of Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and substance abuse in a midwestern university population following the terrorist attacks on September 11, 2001, in New York City and Washington, DC. Three-hundred five subjects volunteered to complete a questionnaire which measured nine areas of psychosocial functioning which included demographics, personality, PTSD, MDD, prior traumatic experiences, alcohol and drug use, psychiatric history and treatment, and current attitudes towards government, religion, the economy, and how children were affected by the events. The participants lived in a large urban city over which United Flight 93 circled before crashing in Pennsylvania due to terrorist attacks. The subjects were forced to evacuate their university and city due to attacks on New York and errant United Flight 93. The study also replicated the first two national studies on PTSD prevalence (Schuster, et al., 2002; Galea, et al., 2002). The results found a prevalence rate of 5.9% for probable PTSD, matching identically previous national surveys. There were higher levels of PTSD and MDD for females, those with less education and who were single or unmarried, and those who had a prior history of mental health problems or psychological trauma. PTSD and MDD were associated with higher levels of alcohol and drug use since September 11. Relations to active duty military personnel appear to moderate the perception of threat, suggesting the importance of affiliative kinship patterns to coping with stress. Finally, the concept of geographic and psychological proximity to the 'zone of danger' is discussed.

Injuries in air transport emergency evacuations.

DOT National Transportation Integrated Search

1979-02-01

Twelve air transport evacuations are reviewed. Injuries are discussed with emphasis on configurational and procedural contributing factors. Recommendations and information about possible methods of reducing injuries are provided.

Diagnoses and factors associated with medical evacuation and return to duty among nonmilitary personnel participating in military operations in Iraq and Afghanistan

PubMed Central

Cohen, Steven P.; Brown, Charlie; Kurihara, Connie; Plunkett, Anthony; Nguyen, Conner; Strassels, Scott A.

2011-01-01

Background Nonmilitary personnel play an increasingly critical role in modern wars. Stark differences exist between the demographic characteristics, training and missions of military and nonmilitary members. We examined the differences in types of injury and rates of returning to duty among nonmilitary and military personnel participating in military operations in Iraq and Afghanistan. Methods We collected data for nonmilitary personnel medically evacuated from military operations in Iraq and Afghanistan between 2004 and 2007. We compared injury categories and return-to-duty rates in this group with previously published data for military personnel and identified factors associated with return to duty. Results Of the 2155 medically evacuated nonmilitary personnel, 74.7% did not return to duty. War-related injuries in this group accounted for 25.6% of the evacuations, the most common causes being combat-related injuries (55.4%) and musculoskeletal/spinal injuries (22.9%). Among individuals with non–war-related injuries, musculoskeletal injuries accounted for 17.8% of evacuations. Diagnoses associated with the highest return-to-duty rates in the group of nonmilitary personnel were psychiatric diagnoses (15.6%) among those with war-related injuries and noncardiac chest or abdominal pain (44.0%) among those with non–war-related injuries. Compared with military personnel, nonmilitary personnel with war-related injuries were less likely to return to duty (4.4% v. 5.9%, p = 0.001) but more likely to return to duty after non–war-related injuries (32.5% v. 30.7%, p = 0.001). Interpretation Compared with military personnel, nonmilitary personnel were more likely to be evacuated with non–war-related injuries but more likely to return to duty after such injuries. For evacuations because of war-related injuries, this trend was reversed. PMID:21324873

Personalized Alert Notifications and Evacuation Routes in Indoor Environments

PubMed Central

Aedo, Ignacio; Yu, Shuxin; Díaz, Paloma; Acuña, Pablo; Onorati, Teresa

2012-01-01

The preparedness phase is crucial in the emergency management process for reaching an adequate level of readiness to react to potential threats and hazards. During this phase, emergency plans are developed to establish, among other procedures, evacuation and emergency escape routes. Information and Communication Technologies (ICT) can support and improve these procedures providing appropriate, updated and accessible information to all people in the affected zone. Current emergency management and evacuation systems do not adapt information to the context and the profile of each person, so messages received in the emergency might be useless. In this paper, we propose a set of criteria that ICT-based systems could achieve in order to avoid this problem adapting emergency alerts and evacuation routes to different situations and people. Moreover, in order to prove the applicability of such criteria, we define a mechanism that can be used as a complement of traditional evacuation systems to provide personalized alerts and evacuation routes to all kinds of people during emergency situations in working places. This mechanism is composed by three main components: CAP-ONES for notifying emergency alerts, NERES for defining emergency plans and generating personalized evacuation routes, and iNeres as the interface to receive and visualize these routes on smartphones. The usability and understandability of proposed interface has been assessed through a user study performed in a fire simulation in an indoor environment. This evaluation demonstrated that users considered iNeres easy to understand, to learn and to use, and they also found very innovative the idea to use smartphones as a support for escaping instead of static signals on walls and doors. PMID:22969373

Critical review and meta-analysis of spurious hemolysis in blood samples collected from intravenous catheters

PubMed Central

Lippi, Giuseppe; Cervellin, Gianfranco; Mattiuzzi, Camilla

2013-01-01

Background: A number of preanalytical activities strongly influence sample quality, especially those related to sample collection. Since blood drawing through intravenous catheters is reported as a potential source of erythrocyte injury, we performed a critical review and meta-analysis about the risk of catheter-related hemolysis. Materials and methods: We performed a systematic search on PubMed, Web of Science and Scopus to estimate the risk of spurious hemolysis in blood samples collected from intravenous catheters. A meta-analysis with calculation of Odds ratio (OR) and Relative risk (RR) along with 95% Confidence interval (95% CI) was carried out using random effect mode. Results: Fifteen articles including 17 studies were finally selected. The total number of patients was 14,796 in 13 studies assessing catheter and evacuated tubes versus straight needle and evacuated tubes, and 1251 in 4 studies assessing catheter and evacuated tubes versus catheter and manual aspiration. A significant risk of hemolysis was found in studies assessing catheter and evacuated tubes versus straight needle and evacuated tubes (random effect OR 3.4; 95% CI = 2.9–3.9 and random effect RR 1.07; 95% CI = 1.06–1.08), as well as in studies assessing catheter and evacuated tubes versus catheter and manual aspiration of blood (OR 3.7; 95% CI = 2.7–5.1 and RR 1.32; 95% CI = 1.24–1.40). Conclusions: Sample collection through intravenous catheters is associated with significant higher risk of spurious hemolysis as compared with standard blood drawn by straight needle, and this risk is further amplified when intravenous catheter are associated with primary evacuated blood tubes as compared with manual aspiration. PMID:23894864

Telemedical Maritime Assistance Service (TMAS) to Swedish merchant and passengers ships 1997-2012.

PubMed

Westlund, Karin; Attvall, Stig; Nilsson, Ralph; Jensen, Olaf C

2016-01-01

Telemedical Maritime Assistance Service (TMAS) for seafarers and traveling passengers is important and can be crucial for the optimal medical treatment on board ships. The aim of this study was to analyse and to compare the data from consultations and evacuations from merchant ships and passenger ferries for possible improvements. Data for seafarers from 1997, 2002 and 2007 and for passengers on Swedish ferries for the years 2007, 2009, 2011 and 2012 from the Swedish Radio Medical were studied. Symptoms and diseases were classified according to the International Classification for Primary Care (ICPC-2). The distribution of symptoms, accidents and diseases, treatments/actions taken, evacuations and the communication forms were analysed. One thousand ninety-five contacts for seafarers from merchant ships and 651 passenger patients from Swedish ferries were analysed. While the evacuations for the seafarers gradually decreased over the years from 18% in 1997 to 14% in 2007, still 39.5% of the passenger patient contacts were evacuated mainly by helicopters and 70 patients were picked up by an ambulance on the quay. Accidents were 20% for seafarers and 25% for passengers of the contacts. Evacuations for passengers were mainly in the diagnostic groups: unspecific (A), digestive (D), cardiology (K), musculoskeletal (L) and neurology (N). The use of VHF, radio communications and fax machines have been greatly reduced while the use of e-mail and satellite phone increased. No significant differences in reasons for contact or actions over the years have been identified. The evacuations of seafarers decreased over the years but was stable among the passenger patients (39%). The circumstances and reasons behind the evacuations should be analysed for prevention. Standard forms and digital images for documentation can facilitate knowledge exchange and further studies.

A Time-Aware Routing Map for Indoor Evacuation †

PubMed Central

Zhao, Haifeng; Winter, Stephan

2016-01-01

Knowledge of dynamic environments expires over time. Thus, using static maps of the environment for decision making is problematic, especially in emergency situations, such as evacuations. This paper suggests a fading memory model for mapping dynamic environments: a mechanism to put less trust on older knowledge in decision making. The model has been assessed by simulating indoor evacuations, adopting and comparing various strategies in decision making. Results suggest that fading memory generally improves this decision making. PMID:26797610

A Markov Decision Process Model for the Optimal Dispatch of Military Medical Evacuation Assets

DTIC Science & Technology

2014-03-27

further background on MEDEVAC and provides a review of pertinent literature . Section 3 provides a de- scription of the problem for which we develop our...best medical evacuation system possible, for those who follow in your footsteps . Special thanks goes to my wife and two children for their...order to generate the computational results necessary to make this paper a success. Lastly, I would like to thank the US Army Medical Evacuation

Efficacy and safety of key hole craniotomy for the evacuation of spontaneous cerebellar hemorrhage.

PubMed

Tokimura, Hiroshi; Tajitsu, Kenichiro; Taniguchi, Ayumi; Yamahata, Hitoshi; Tsuchiya, Masahiro; Takayama, Kenji; Shinsato, Tomomi; Arita, Kazunori

2010-01-01

The efficacy and safety of cerebellar hemorrhage evacuation by key hole craniotomy and the importance of thorough evacuation and irrigation of the hematoma in the fourth ventricle to resolve obstructive hydrocephalus were assessed in 23 patients with spontaneous cerebellar hemorrhage (SCH) greater than 3 cm or with brainstem compression and hydrocephalus. A 5-cm elongated S-shaped scalp incision was made, and a 3-cm key hole craniotomy was performed over a cerebellar convexity area. The hematoma was immediately evacuated through a small corticotomy. The hematoma in the fourth ventricle was gently removed through the hematoma cavity, followed by thorough saline irrigation to release obstructive hydrocephalus. Patients classified retrospectively into favorable and poor outcome groups using the Glasgow Outcome Scale (GOS) scores of 4-5 vs. 1-3 showed significant differences with respect to the preoperative Glasgow Coma Scale, hematoma size and volume, and brainstem compression. Only 2 of the 23 patients required ventricular drainage and no postoperative complications were recorded. Patients treated by experienced and inexperienced surgeons showed no significant differences in the hematoma evacuation rate, postoperative GOS, and interval from skin incision to start of hematoma evacuation. Our simplified method of key hole craniotomy to treat SCH was less invasive but easy to perform, as even inexperienced neurosurgeons could obtain good surgical results. Thorough cleaning of the fourth ventricle minimized the necessity for ventricular drainage.

Preanalytical Nonconformity Management Regarding Primary Tube Mixing in Brazil.

PubMed

Lima-Oliveira, Gabriel; Cesare Guidi, Gian; Guimaraes, Andre Valpassos Pacifici; Abol Correa, Jose; Lippi, Giuseppe

2017-01-01

The multifaceted clinical laboratory process is divided in three essential phases: the preanalytical, analytical and postanalytical phase. Problems emerging from the preanalytical phase are responsible for more than 60% of laboratory errors. This report is aimed at highlighting and discussing nonconformity (e.g., nonstandardized procedures) in primary blood tube mixing immediately after blood collection by venipuncture with evacuated tube systems. From January 2015 to December 2015, fifty different laboratory quality managers from Brazil were contacted to request their internal audit reports on nonconformity regarding primary blood tube mixing immediately after blood collection by venipuncture performed using evacuated tube systems. A minority of internal audits (i.e., 4%) concluded that evacuated blood tubes were not accurately mixed after collection, whereas more than half of them reported that evacuated blood tubes were vigorously mixed immediately after collection, thus magnifying the risk of producing spurious hemolysis. Despite the vast ma jority of centers declaring that evacuated blood tubes were mixed gently and carefully, the overall number of inversions was found to be different from that recommended by the manufacturer. Since the turbulence generated by the standard vacuum pressure inside the primary evacuated tubes seems to be sufficient for providing solubilization, mixing and stabilization between additives and blood during venipuncture, avoidance of primary tube mixing probably does not introduce a major bias in tests results and may not be considered a nonconformity during audits for accreditation.

Factors Affecting Household Adoption of an Evacuation Plan in American Samoa after the 2009 Earthquake and Tsunami

PubMed Central

Gregg, Chris E; Richards, Kasie; Sorensen, Barbara Vogt; Wang, Liang

2013-01-01

American Samoa is still recovering from the debilitating consequences of the September 29, 2009 tsunami. Little is known about current household preparedness in American Samoa for future earthquakes and tsunamis. Thus, this study sought to enumerate the number of households with an earthquake and tsunami evacuation plan and to identify predictors of having a household evacuation plan through a post-tsunami survey conducted in July 2011. Members of 300 households were interviewed in twelve villages spread across regions of the principle island of Tutuila. Multiple logistic regression showed that being male, having lived in one's home for < 30 years, and having a friend who suffered damage to his or her home during the 2009 tsunami event increased the likelihood of having a household evacuation plan. The prevalence of tsunami evacuation planning was 35% indicating that survivors might feel that preparation is not necessary given effective adaptive responses during the 2009 event. Results suggest that emergency planners and public health officials should continue with educational outreach to families to spread awareness around the importance of developing plans for future earthquakes and tsunamis to help mitigate human and structural loss from such natural disasters. Additional research is needed to better understand the linkages between pre-event planning and effective evacuation responses as were observed in the 2009 events. PMID:24349889

Factors affecting household adoption of an evacuation plan in American Samoa after the 2009 earthquake and tsunami.

PubMed

Apatu, Emma J I; Gregg, Chris E; Richards, Kasie; Sorensen, Barbara Vogt; Wang, Liang

2013-08-01

American Samoa is still recovering from the debilitating consequences of the September 29, 2009 tsunami. Little is known about current household preparedness in American Samoa for future earthquakes and tsunamis. Thus, this study sought to enumerate the number of households with an earthquake and tsunami evacuation plan and to identify predictors of having a household evacuation plan through a post-tsunami survey conducted in July 2011. Members of 300 households were interviewed in twelve villages spread across regions of the principle island of Tutuila. Multiple logistic regression showed that being male, having lived in one's home for < 30 years, and having a friend who suffered damage to his or her home during the 2009 tsunami event increased the likelihood of having a household evacuation plan. The prevalence of tsunami evacuation planning was 35% indicating that survivors might feel that preparation is not necessary given effective adaptive responses during the 2009 event. Results suggest that emergency planners and public health officials should continue with educational outreach to families to spread awareness around the importance of developing plans for future earthquakes and tsunamis to help mitigate human and structural loss from such natural disasters. Additional research is needed to better understand the linkages between pre-event planning and effective evacuation responses as were observed in the 2009 events.

Should I Stay or Should I Go Now? Or Should I Wait and See? Influences on Wildfire Evacuation Decisions.

PubMed

McCaffrey, Sarah; Wilson, Robyn; Konar, Avishek

2017-11-23

As climate change has contributed to longer fire seasons and populations living in fire-prone ecosystems increase, wildfires have begun to affect a growing number of people. As a result, interest in understanding the wildfire evacuation decision process has increased. Of particular interest is understanding why some people leave early, some choose to stay and defend their homes, and others wait to assess conditions before making a final decision. Individuals who tend to wait and see are of particular concern given the dangers of late evacuation. To understand what factors might influence different decisions, we surveyed homeowners in three areas in the United States that recently experienced a wildfire. The Protective Action Decision Model was used to identify a suite of factors previously identified as potentially relevant to evacuation decisions. Our results indicate that different beliefs about the efficacy of a particular response or action (evacuating or staying to defend), differences in risk attitudes, and emphasis on different cues to act (e.g., official warnings, environmental cues) are key factors underlying different responses. Further, latent class analysis indicates there are two general classes of individuals: those inclined to evacuate and those inclined to stay, and that a substantial portion of each class falls into the wait and see category. © 2017 Society for Risk Analysis.

Digestive tract evacuation in northern squawfish (Ptychocheilus oregonensis)

USGS Publications Warehouse

Beyer, J.M.; Lucchetti, G.; Gray, G.

1988-01-01

Digestive tract evacuation in northern squawfish (Ptychocheilus oregonensis) (170–1900 g) was studied in fish allowed to feed voluntarily on salmon (4–70 g) at three water temperatures (10, 15, and 20 °C). Squawfish were sacrificed at 1- or 2-h intervals until evacuation approximated 90%. Amount of food evacuated for a given time interval increased approximately three times as the temperature was increased and as the prey weight was increased and two times as the predator weight was increased. The 90% emptying time (ET90) decreased by about two thirds as the temperature doubled and by about one half as the predator weight increased 10 times, but approximately doubled when the prey weight increased 4 times. Two-fish meals (17–20 g each, 35–39 g total) were evacuated more slowly than meals of one fish weighing 17–20 g, but at the same rate as meals of one fish weighing 35–40 g. Equations derived are easily applied to a wide range of water temperatures, prey weights, and predator weights.

Pedestrian collective motion in competitive room evacuation.

PubMed

Garcimartín, A; Pastor, J M; Martín-Gómez, C; Parisi, D; Zuriguel, I

2017-09-07

When a sizable number of people evacuate a room, if the door is not large enough, an accumulation of pedestrians in front of the exit may take place. This is the cause of emerging collective phenomena where the density is believed to be the key variable determining the pedestrian dynamics. Here, we show that when sustained contact among the individuals exists, density is not enough to describe the evacuation, and propose that at least another variable -such as the kinetic stress- is required. We recorded evacuation drills with different degrees of competitiveness where the individuals are allowed to moderately push each other in their way out. We obtain the density, velocity and kinetic stress fields over time, showing that competitiveness strongly affects them and evidencing patterns which have been never observed in previous (low pressure) evacuation experiments. For the highest competitiveness scenario, we detect the development of sudden collective motions. These movements are related to a notable increase of the kinetic stress and a reduction of the velocity towards the door, but do not depend on the density.

Evacuation performance evaluation tool.

PubMed

Farra, Sharon; Miller, Elaine T; Gneuhs, Matthew; Timm, Nathan; Li, Gengxin; Simon, Ashley; Brady, Whittney

2016-01-01

Hospitals conduct evacuation exercises to improve performance during emergency events. An essential aspect in this process is the creation of reliable and valid evaluation tools. The objective of this article is to describe the development and implications of a disaster evacuation performance tool that measures one portion of the very complex process of evacuation. Through the application of the Delphi technique and DeVellis's framework, disaster and neonatal experts provided input in developing this performance evaluation tool. Following development, content validity and reliability of this tool were assessed. Large pediatric hospital and medical center in the Midwest. The tool was pilot tested with an administrative, medical, and nursing leadership group and then implemented with a group of 68 healthcare workers during a disaster exercise of a neonatal intensive care unit (NICU). The tool has demonstrated high content validity with a scale validity index of 0.979 and inter-rater reliability G coefficient (0.984, 95% CI: 0.948-0.9952). The Delphi process based on the conceptual framework of DeVellis yielded a psychometrically sound evacuation performance evaluation tool for a NICU.

Predation rates by North Sea cod (Gadus morhua) - Predictions from models on gastric evacuation and bioenergetics

USGS Publications Warehouse

Hansson, S.; Rudstam, L. G.; Kitchell, J.F.; Hilden, M.; Johnson, B.L.; Peppard, P.E.

1996-01-01

We compared four different methods for estimating predation rates by North Sea cod (Gadus moi hua). Three estimates, based on gastric evacuation rates, came from an ICES multispecies working group and the fourth from a bioenergetics model. The bioenergetics model was developed from a review of literature on cod physiology. The three gastric evacuation rate models produced very different prey consumption estimates for small (2 kg) fish. For most size and age classes, the bioenergetics model predicted food consumption rates intermediate to those predicted by the gastric evacuation models. Using the standard ICES model and the average population abundance and age structure for 1974-1989, annual, prey consumption by the North Sea cod population (age greater than or equal to 1) was 840 kilotons. The other two evacuation rate models produced estimates of 1020 and 1640 kilotons, respectively. The bioenergetics model estimate was 1420 kilotons. The major differences between models were due to consumption rate estimates for younger age groups of cod. (C) 1996 International Council for the Exploration of the Sea

Decision analysis of emergency ventilation and evacuation strategies against suddenly released contaminant indoors by considering the uncertainty of source locations.

PubMed

Cai, Hao; Long, Weiding; Li, Xianting; Kong, Lingjuan; Xiong, Shuang

2010-06-15

In case hazardous contaminants are suddenly released indoors, the prompt and proper emergency responses are critical to protect occupants. This paper aims to provide a framework for determining the optimal combination of ventilation and evacuation strategies by considering the uncertainty of source locations. The certainty of source locations is classified as complete certainty, incomplete certainty, and complete uncertainty to cover all the possible situations. According to this classification, three types of decision analysis models are presented. A new concept, efficiency factor of contaminant source (EFCS), is incorporated in these models to evaluate the payoffs of the ventilation and evacuation strategies. A procedure of decision-making based on these models is proposed and demonstrated by numerical studies of one hundred scenarios with ten ventilation modes, two evacuation modes, and five source locations. The results show that the models can be useful to direct the decision analysis of both the ventilation and evacuation strategies. In addition, the certainty of the source locations has an important effect on the outcomes of the decision-making. Copyright 2010 Elsevier B.V. All rights reserved.

Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results.

PubMed

Erdem, Suna; Imboden, Sara; Papadia, Andrea; Lanz, Susanne; Mueller, Michael D; Gloor, Beat; Worni, Mathias

2018-06-01

Curative management of deep infiltrating endometriosis requires complete removal of all endometriotic implants. Surgical approach to rectal involvement has become a topic of debate given potential postoperative bowel dysfunction and complications. This study aims to assess long-term postoperative evacuation and incontinence outcomes after laparoscopic segmental rectal resection for deep infiltrating endometriosis involving the rectal wall. This is a retrospective study of prospectively collected data. This single-center study was conducted at the University Hospital of Bern, Switzerland. Patients with deep infiltrating endometriosis involving the rectum undergoing rectal resection from June 2002 to May 2011 with at least 24 months follow-up were included. Aside from endometriosis-related symptoms, detailed symptoms on evacuation (points: 0 (best) to 21 (worst)) and incontinence (0-24) were evaluated by using a standardized questionnaire before and at least 24 months after surgery. Of 66 women who underwent rectal resection, 51 were available for analyses with a median follow-up period of 86 months (range: 26-168). Forty-eight patients (94%) underwent laparoscopic resection (4% converted, 2% primary open), with end-to-end anastomosis in 41 patients (82%). Two patients (4%) had an anastomotic insufficiency; 1 case was complicated by rectovaginal fistula. Dysmenorrhea, nonmenstrual pain, and dyspareunia substantially improved (p < 0.001 for all comparisons). Overall evacuation score increased from a median of 0 (range: 0-11) to 2 points (0-15), p = 0.002. Overall incontinence also increased from 0 (range: 0-9) to 2 points (0-9), p = 0.003. This study was limited by its retrospective nature and moderate number of patients. Laparoscopic segmental rectal resection for the treatment of deep infiltrating endometriosis including the rectal wall is associated with good results in endometriotic-related symptoms, although patients should be informed about possible postoperative impairments in evacuation and incontinence. However, its clinical impact does not outweigh the benefit that can be achieved through this approach. See Video Abstract at http://links.lww.com/DCR/A547.

[Organization of anesthesia management and advanced life support at military medical evacuation levels].

PubMed

Shchegolev, A V; Petrakov, V A; Savchenko, I F

2014-07-01

Anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels in armed conflict (local war) is time-consuming and resource-requiring task. One of the mathematical modeling methods was used to evaluate capabilities of anesthesia and intensive care units at tactical level. Obtained result allows us to tell that there is a need to make several system changes of the existing system of anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels. In addition to increasing number of staff of anesthesiology-critical care during the given period of time another solution should be the creation of an early evacuation to a specialized medical care level by special means while conducting intensive monitoring and treatment.

ABM and GIS-based multi-scenarios volcanic evacuation modelling of Merapi

NASA Astrophysics Data System (ADS)

Jumadi, Carver, Steve; Quincey, Duncan

2016-05-01

Conducting effective evacuation is one of the successful keys to deal with such crisis. Therefore, a plan that considers the probability of the spatial extent of the hazard occurrences is needed. Likewise, the evacuation plan in Merapi is already prepared before the eruption on 2010. However, the plan could not be performed because the eruption magnitude was bigger than it was predicted. In this condition, the extent of the hazardous area was increased larger than the prepared hazard model. Managing such unpredicted situation need adequate information that flexible and adaptable to the current situation. Therefore, we applied an Agent-based Model (ABM) and Geographic Information System (GIS) using multi-scenarios hazard model to support the evacuation management. The methodology and the case study in Merapi is provided.

30 CFR 46.11 - Site-specific hazard awareness training.

Code of Federal Regulations, 2011 CFR

2011-07-01

... environmental conditions, recognition and avoidance of hazards such as electrical and powered-haulage hazards, traffic patterns and control, and restricted areas; and warning and evacuation signals, evacuation and...

Analysis of Local Planning Interviews.

DTIC Science & Technology

1984-04-01

Suite 121, P.O. Box 2487 Project No. 4813-D Kirkland, WA 98033 II. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE Federal Emergency Management...Agency April 1984 Washington, D.C. 20472 13. NUMBER OF PAGES31 14. MONITORING AGENCY NAME & ADDRESS(If different from Controlling Office) IS. SECURITY...and Control and the basic emergency functions (Warning, RADEF, Law Enforcement, Fire, Communications, Public Information, Health, Medical, Evacuation

Modeling social crowds. Comment on "Human behaviours in evacuation crowd dynamics: From modelling to "big data" toward crisis management" by Nicola Bellomo et al.

NASA Astrophysics Data System (ADS)

Poyato, David; Soler, Juan

2016-09-01

The study of human behavior is a complex task, but modeling some aspects of this behavior is an even more complicated and exciting idea. From crisis management to decision making in evacuation protocols, understanding the complexity of humans in stress situations is more and more demanded in our society by obvious reasons [5,6,8,12]. In this context, [4] deals with crowd dynamics with special attention to evacuation.

Management of pneumothorax in cattle by continuous-flow evacuation.

PubMed

Peek, Simon E; Slack, J A; McGuirk, Sheila M

2003-01-01

Pneumothorax in cattle can develop subsequent to acute or chronic pulmonary disease, and if unresolved may lead to respiratory distress and death due to hypoxia and compression and collapse of cardiac and thoracic great vessels. Therapeutic evacuation of free air within the pleural space can provide acute relief and improve chances of survival. This article descibes the adaptation and use of a continuous flow evacuation device to resolve pneumothorax in 3 cattle with pneumothorax associated with infectious lower airway disease.

Journal of Special Operations Medicine, Volume 7, Edition 4. Training Supplement: Tactics, Techniques, and Procedures

DTIC Science & Technology

2007-01-01

fatigued. The majority of the OIL and TTP listed here are oriented to the Level I management of combat CAX or management at the point of injury (POI) or...carried into the field by medical personnel. Time to evacuation from the POI or other casualty evacuation point (CEP) to an MTF may vary considerably...must be avoided during this time. Care must be rendered once the mission has reached an anticipated evacuation point , without pursuit, awaiting CASEVAC

Simulation Tool for Optimizing Non-Combatant Evacuation (STONE): Optimization of Evacuation Time and Transportation Resource Utilization

DTIC Science & Technology

2015-05-01

2015 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2015 Abstract A Non-Combatant Evacuation...Standing Senate Committee on Foreign Affairs and International Trade recommended that more frequent assessments of NEO plans be conducted...étrangères et du commerce international a recommandé que des évaluations dans ses missions à l’étranger soient faites plus fréquemment