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Casualties
Kinds of Casualties Selected AbstractsCasualties of the Iraq WarDIALOG, Issue 2 2006Article first published online: 10 MAY 200 No abstract is available for this article. [source] Combat Stress Casualties in Iraq.PERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2008Part 1: Behavioral Health Consultation at an Expeditionary Medical Group PURPOSE.,We review the role of military mental health professionals in consulting with inpatient medical patients and staff at a combat hospital and aeromedical evacuation staging facility in Iraq. CONCLUSIONS.,Behavioral health consultation with medical and surgical patients during hospitalization and prior to aeromedical evacuation can help identify patients with combat stress exposure that may require future mental health follow-up. PRACTICE IMPLICATIONS.,Extensive use of civilian mental health practitioners including nurse psychotherapists and psychiatric nurse practitioners will be needed to provide psychiatric care for the large number of U.S. veterans who return from deployment with combat stress related disorders. [source] McGrath v Riddell: A flexible approach to the insolvency distribution rules?INTERNATIONAL INSOLVENCY REVIEW, Issue 1 2010Blanca Mamutse The rules relating to the division of the insolvent estate assume considerable importance in the field of international insolvencies, where different legal systems interact. International instruments including the European insolvency regulation and the UNCITRAL Model Law on Cross-Border Insolvency have provided a framework which governs the relationship between local and foreign distribution schemes. For English lawyers, questions remain however regarding the future role of the courts' statutory power to cooperate with the courts of ,relevant' countries or territories, and of the common law principle of universalism. An important issue connected to the determination of such questions is the established judicial approach to the pari passu rule, in the application of domestic law. This paper examines the manifestation of this tension in the litigation arising from the collapse of the HIH Casualty & General Insurance group of companies. It notes the scope which remains for continued resort to the statutory power of cooperation, and the potential for the Cross-Border Insolvency Regulations 2006 to encourage a more flexible approach to resolving differences between distribution schemes. Copyright © 2010 John Wiley & Sons, Ltd. [source] The Art and Science of Surge: Experience from Israel and the U.S. MilitaryACADEMIC EMERGENCY MEDICINE, Issue 11 2006Boaz Tadmor MD In a disaster or mass casualty incident, health care resources may be exceeded and systems may be challenged by unusual requirements. These resources may include pharmaceuticals, supplies, and equipment as well as certain types of academic and administrative expertise. New agencies and decision makers may need to work together in an unfamiliar environment. Furthermore, large numbers of casualties needing treatment, newer therapies required to care for these casualties, and increased workforce and space available for these casualties all contribute to what is often referred to as "surge." Surge capacity in emergency care can be described in technical, scientific terms that are measured by numbers and benchmarks (e.g., beds, patients, and medications) or can take on a more conceptual and abstract form (e.g., decisions, authority, and responsibility). The former may be referred to as the "science" of surge, whereas the latter, an equal if not more important component of surge systems that is more conceptual and abstract, can be considered the "art" of surge. The experiences from Israel and the U.S. military may serve to educate colleagues who may be required to respond or react to an event that taxes the current health care system. This report presents concrete examples of surge capacity strategies used by both Israel and the U.S. military and provides solutions that may be applied to other health care systems when faced with similar situations. [source] A Single Ventilator for Multiple Simulated Patients to Meet Disaster SurgeACADEMIC EMERGENCY MEDICINE, Issue 11 2006Greg Neyman MD Objectives To determine if a ventilator available in an emergency department could quickly be modified to provide ventilation for four adults simultaneously. Methods Using lung simulators, readily available plastic tubing, and ventilators (840 Series Ventilator; Puritan-Bennett), human lung simulators were added in parallel until the ventilator was ventilating the equivalent of four adults. Data collected included peak pressure, positive end-expiratory pressure, total tidal volume, and total minute ventilation. Any obvious asymmetry in the delivery of gas to the lung simulators was also documented. The ventilator was run for almost 12 consecutive hours (5.5 hours of pressure control and more than six hours of volume control). Results Using readily available plastic tubing set up to minimize dead space volume, the four lung simulators were easily ventilated for 12 hours using one ventilator. In pressure control (set at 25 mm H2O), the mean tidal volume was 1,884 mL (approximately 471 mL/lung simulator) with an average minute ventilation of 30.2 L/min (or 7.5 L/min/lung simulator). In volume control (set at 2 L), the mean peak pressure was 28 cm H2O and the minute ventilation was 32.5 L/min total (8.1 L/min/lung simulator). Conclusions A single ventilator may be quickly modified to ventilate four simulated adults for a limited time. The volumes delivered in this simulation should be able to sustain four 70-kg individuals. While further study is necessary, this pilot study suggests significant potential for the expanded use of a single ventilator during cases of disaster surge involving multiple casualties with respiratory failure. [source] Suicide bombings: process of care of mass casualties in the developing worldDISASTERS, Issue 4 2009Masood Umer In recent times Pakistan's biggest city, Karachi, has witnessed numerous terrorist attacks. The city does not have an emergency response system and only one of the three public sector hospitals has a trauma centre. We describe the pattern of injuries and management of two terror-related mass casualty incidents involving suicide bombers in a developing nation with limited resources. The first incident occurred in May 2002 with 36 casualties, of whom 13 (36%) died immediately and 11 (30.5%) died at the primary receiving hospitals. The second incident was targeted against the local population in May 2004. The blast resulted in 104 casualties, of which 14 (13.46%) died at the site. All patients had their initial assessment and treatment based on Advanced Trauma and Life Support principles and documented on a trauma form. [source] Social vulnerability and the natural and built environment: a model of flood casualties in TexasDISASTERS, Issue 4 2008Sammy Zahran Studies on the impacts of hurricanes, tropical storms, and tornados indicate that poor communities of colour suffer disproportionately in human death and injury., Few quantitative studies have been conducted on the degree to which flood events affect socially vulnerable populations. We address this research void by analysing 832 countywide flood events in Texas from 1997,2001. Specifically, we examine whether geographic localities characterised by high percentages of socially vulnerable populations experience significantly more casualties due to flood events, adjusting for characteristics of the natural and built environment. Zero-inflated negative binomial regression models indicate that the odds of a flood casualty increase with the level of precipitation on the day of a flood event, flood duration, property damage caused by the flood, population density, and the presence of socially vulnerable populations. Odds decrease with the number of dams, the level of precipitation on the day before a recorded flood event, and the extent to which localities have enacted flood mitigation strategies. The study concludes with comments on hazard-resilient communities and protection of casualty-prone populations. [source] The Economics of Landmine Clearance in AfghanistanDISASTERS, Issue 1 2002Geoff Harris This paper presents an economic evaluation of landmine clearance in Afghanistan. The main benefits comprise increased agricultural output, saved transport time and running costs, saved human casualties and the saved costs of supporting refugees and displaced persons. An investment of US$100 million between 1988 and 1998 is estimated to provide annual benefits of $50.3 million per annum between 1999 and 2008. This translates into net present values of between $935 and $1,744 million, depending on the rate of discount used. This contrasts with the negative NPVs estimated for several other countries. [source] Information Technology and Emergency Medical Care during DisastersACADEMIC EMERGENCY MEDICINE, Issue 11 2004Theodore C. Chan MD Abstract Disaster response to mass-casualty incidents represents one of the greatest challenges to a community's emergency response system. Rescuers, field medical personnel, and regional emergency departments and hospitals must often provide care to large numbers of casualties in a setting of limited resources, inadequate communication, misinformation, damaged infrastructure, and great personal risk. Emergency care providers and incident managers attempt to procure and coordinate resources and personnel, often with inaccurate data regarding the true nature of the incident, needs, and ongoing response. In this chaotic environment, new technologies in communications, the Internet, computer miniaturization, and advanced "smart devices" have the potential to vastly improve the emergency medical response to such mass-casualty incident disasters. In particular, next-generation wireless Internet and geopositioning technologies may have the greatest impact on improving communications, information management, and overall disaster response and emergency medical care. These technologies have applications in terms of enhancing mass-casualty field care, provider safety, field incident command, resource management, informatics support, and regional emergency department and hospital care of disaster victims. [source] A Multicasualty Event: Out-of-hospital and In-hospital Organizational AspectsACADEMIC EMERGENCY MEDICINE, Issue 10 2004Malka Avitzour MPH Abstract In a wedding celebration of 700 participants, the third floor of the hall in which the celebration was taking place suddenly collapsed. While the walls remained intact, all three floors of the building collapsed, causing Israel's largest disaster. Objectives: To study the management of a multicasualty event (MCE), in the out-of-hospital and in-hospital phases, including rescue, emergency medical services (EMS) deployment and evacuation of casualties, emergency department (ED) deployment, recalling staff, medical care, imaging procedures, hospitalization, secondary referral, and interhospital transfer of patients. Methods: Data on all the victims who arrived at the four EDs in Jerusalem were collected through medical files, telephone interviews, and hospital computerized information. Results: The disaster resulted in 23 fatalities and 315 injured people; 43% were hospitalized. During the first hour, 42% were evacuated and after seven hours the scene was empty. Ninety-seven basic life support ambulances, 18 mobile intensive care units, 600 emergency medical technicians, 40 paramedics, and 15 physicians took part in the out-of-hospital stage. At the hospitals, about 1,300 staff members arrived immediately, either on demand or voluntarily, a number that seems too large for this disaster. Computed tomography (CT) demand was over its capability. Conclusions: During this MCE, the authors observed "rotating" bottleneck phenomena within out-of-hospital and in-hospital systems. For maximal efficiency, hospitals need to fully coordinate the influx and transfer of patients with out-of-hospital rescue services as well as with other hospitals. Each hospital has to immediately deploy its operational center, which will manage and monitor the hospital's resources and facilitate coordination with the relevant institutions. [source] Growing Up in Guerrilla Camp: The long-Term Impact of Being a Child Soldier in El Salvador's Civil WarETHOS, Issue 4 2002Julia Dickson-Gõmez Many recent wars are characterized by high levels of civilian casualties, a large proportion of whom are women and children. Furthermore, an estimated 300,000 children are actively participating in 36 ongoing or recently ended conflicts around the world. However, there is a dearth of research on the long-term effects of war trauma experienced in childhood or children's active participation in armed conflicts. This article explores the long-term effects of children's active participation in the war in El Salvador by examining four young adults who fought with the guerrilla army as children and adolescents. Comparing these four cases with members of the community who joined and fought with the guerrilla as adults, it will be argued that traumatic experiences were even more devastating when they occurred in early childhood as they destroyed the ability to establish basic trust in competent and nurturing caretakers. Becoming a soldier created additional conflicts as these adolescent soldiers behaved in ways they felt were morally incorrect. Adolescent soldiers were also not given the opportunity to develop autonomy and learn adult peace-time roles. Both the psychological trauma suffered as children as well as continued economic scarcity and violence contribute to these campesinos' difficulties in creating meaningful lives as adults. [source] The Haiti Earthquake: a salutary lesson in (non) earthquake engineeringGEOLOGY TODAY, Issue 2 2010Peter Styles A devastating earthquake of magnitude 7 struck very close and almost beneath Port au Prince the capital of Haiti, the western half of the island of Hispaniola, early in the morning of Tuesday, 12 January 2010 (Fig. 1). While in absolute terms this was by no means the largest earthquake recorded this year globally, the death toll is around 230 000, making it one of the world's worst earthquakes in terms of casualties in recorded history, with almost uncountable economic loss to one of the poorest countries in the world. Figure 1. Intensity map of 2010 Haiti earthquake (Image: USGS). [source] Health and Safety in the Medieval Monasteries of BritainHISTORY, Issue 309 2008JULIE KERR The arduous nature of monastic life could impact on the monks' physical and mental well-being, causing minor injuries but also fatalities. Back problems might develop from ringing the heavy monastery bells, digestive disorders could result from years of fasting, and those holding important offices invariably suffered from stress and strain. There has been significant discussion of healthcare in the monastery , of disease and illness, the treatment of the sick, the infirmary, and the role of professional practitioners within the monastery. Less consideration has been given to the various hazards that might affect the monks on a daily basis, from the obstacles that caused them to trip and tumble to the injuries and fatalities that could result from natural disasters, outbreaks of fire and faulty repair work. This article seeks to explore more fully the perils and pitfalls that the religious community might face, but includes a brief discussion of the general impact of monastic observance on the monks' well-being, and the spiritual and physical recourse they sought to prevent mishaps and to treat casualties. Analysis centres on the monastic houses of Britain in the high middle ages, but refers to later and continental examples for comparative purposes and where they are likely to be indicative of conditions in Britain in the twelfth and thirteenth centuries. [source] Griefing in virtual worlds: causes, casualties and coping strategiesINFORMATION SYSTEMS JOURNAL, Issue 6 2009Thomas Chesney Abstract A virtual world is a computer-simulated three-dimensional environment. They are increasingly being used for social and commercial interaction, in addition to their original use for game playing. This paper studies negative behaviour, or ,griefing', inside one virtual world through a series of observations and focus groups with users. Data were collected to identify griefing behaviours and their impact, examine why griefing happens and who the likely targets and perpetrators are, and suggest strategies for coping with it. Findings show that griefing behaviour is common. It is defined as unacceptable, persistent behaviour and is typically targeted at inexperienced residents by those with more knowledge of the virtual world. Community and individual coping strategies are identified and discussed. [source] The New Law of War: Legitimizing Hi,Tech and Infrastructural ViolenceINTERNATIONAL STUDIES QUARTERLY, Issue 3 2002Thomas W. Smith This article examines how humanitarian laws of war have been recast in light of a new generation of hi,tech weapons and innovations in strategic theory. Far from falling into disuse, humanitarian law is invoked more frequently than ever to confer legitimacy on military action. New legal interpretations, diminished ad bellum rules, and an expansive view of military necessity are coalescing in a regime of legal warfare that licenses hi,tech states to launch wars as long as their conduct is deemed just. The ascendance of technical legalism has undercut customary restraints on the use of armed force and has opened a legal chasm between technological haves and have,nots. Most striking is the use of legal language to justify the erosion of distinctions between soldiers and civilians and to legitimize collateral damage. Hi,tech warfare has dramatically curbed immediate civilian casualties, yet the law sanctions infrastructural campaigns that harm long,term public health and human rights in ways that are now clear. [source] Characteristics of river floods and flooding: a global overview, 1985,2003,,IRRIGATION AND DRAINAGE, Issue S1 2006Klaas-Jan Douben inondation; victims; dommages; stratégies de protection contre les inundations Abstract Since ancient times people have settled in flood-prone areas due to favourable geographic conditions which facilitate economic growth, such as accessibility (transportation) and food production (fertile land). This fact forces societies all over the world to protect valuable assets against flooding. Nevertheless flooding is still the most damaging of all natural disasters. One-third of the annual natural disasters and economic losses and more than half of all victims are flood related. Flood mitigation policies and measures have been implemented, enabling societies to increase their resilience to flood hazards. With increasing population densities, often associated with improved living standards and consequently higher values of property and infrastructure, flood defence receives more importance and the consequences of flooding become less acceptable. Trends in flood frequencies and flooding damage seem to be increasing, primarily due to a growing vulnerability arising from societal changes such as interference by occupation, developments, investments and land-use changes in flood-prone areas. The Asian continent was particularly affected by floods and flooding between 1985 and 2003. It recorded nearly half of all flooding events; together with Europe and North America it was confronted with the majority of flooding damage and it incurred nearly three-quarters of all casualties. Copyright © 2006 John Wiley & Sons, Ltd. Depuis toujours les populations se sont installées dans les zones à risque d'inondation du fait de conditions géographiques favorables à la croissance économique, telles que l'accessibilité (transport) et la production de nourriture (terre fertile). Ceci oblige les sociétés partout dans le monde à protéger les biens contre les inondations. Mais celles-ci sont toujours les plus préjudiciables de tous les désastres naturels. Chaque année, un tiers des désastres naturels et des dommages économiques ainsi que plus de la moitié des victimes sont liés aux inondations. Des politiques et des actions de protection contre les inondations ont été mises en oeuvre, permettant aux sociétés d'augmenter leur résistivité aux risques d'inondation. Avec l'augmentation des densités de population, souvent liée à la progression des niveaux de vie et donc à la valeur plus élevée des habitations et des infrastructures, la protection contre les inondations devient plus importante et leurs conséquences moins acceptables. La fréquence des inondations et de leurs dommages semble en augmentation, principalement en raison d'une vulnérabilité croissante résultant de changements sociaux tels que les interférences des activités, aménagements, investissements et occupation de l'espace dans les zones à risque. Le continent asiatique a été particulièrement affecté entre 1985 et 2003. Il a enregistré presque la moitié de tous les événements d'inondation, a dû faire face à la majorité des dommages avec l'Europe et l'Amérique du Nord et a compté presque trois quarts de toutes les victimes. Copyright © 2006 John Wiley & Sons, Ltd. [source] Mathematically Assessing the Consequences of Food Terrorism ScenariosJOURNAL OF FOOD SCIENCE, Issue 7 2008Y. Liu ABSTRACT:, We derive mathematical expressions for the mean number of casualties resulting from a deliberate release of a biological or chemical agent into a food supply chain. Our analysis first computes the amount of contaminated food as a function of the network topology and vessel sizes in the food processing plant. A probabilistic analysis, in which each potential consumer of contaminated food has his own random purchase time, infectious dose, and incubation period, determines the number of people who consume enough tainted food to get infected or poisoned before the attack is detected and food consumption is halted. These simple formulas can be used by the U.S. government and the food industry to develop a rough-cut prioritization of the threats from food terrorism, which would be a 1st step toward the allocation of appropriate prevention and mitigation resources. [source] Alcohol is the Main Factor in Excess Traffic Accident Fatalities in FranceALCOHOLISM, Issue 12 2002Michel Reynaud Background The aim of this study was to better evaluate the role of alcohol drinking in fatalities linked to road traffic accidents. Methods The data of accidents were collected by a French official agency from police records, including many variables, among which was a blood alcohol test. They were analyzed in a descriptive way and toward a logistic regression. This exhaustive database comprised all of the 500,961 accidents with casualties that involved less than three vehicles (28,506 fatal accidents) recorded in France during a 52 month period (September 1995 to December 1999). The results of the alcohol tests were known in 78.7 of the drivers. Results The blood alcohol concentration was over the legal limit (0.50 g/L in France) in 9.8% of the accidents with casualties overall. Considering only fatal accidents, the rate of positive alcohol test in drivers was approximately 31.5%. This rate varied depending on the period and the type of accident, raising up to 71.2% in single-vehicle accidents (loss of control) at night during the weekend. The percentage of positive alcohol tests also dramatically increased following the number of fatalities per accident (87.5% in single-vehicle accidents during weekend nights involving three or more killed). The logistic regression in single-vehicle accident shows that the higher odds ratios concern the positive blood alcohol test (OR = 4.19), clearly overwhelming the other precipitating factors of accidents (age of driver, meteorological conditions, time of day, and other factors). Conclusions Drinking alcohol before driving is a well known factor of accidents. We clearly demonstrate here that it is the main factor leading to deaths linked to road traffic accidents in France. The results are strengthened, and some analyses are allowed, by the exceptional features of our database. The authors emphasize the need for prevention measures. [source] Transboundary River Floods and Institutional Capacity,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 3 2009Marloes H.N. Bakker Abstract:, While transboundary flood events have become more frequent on a global scale the past two decades, they appear to be overlooked in the international river basin (IRB) cooperation and management arena. The present study therefore combined geopolitical measures with biophysical and socioeconomic variables in an attempt to identify the IRBs with adequate institutional capacity for management of transboundary floods. It also classified basins that would possibly benefit from enlarging the institutional capacity related to transboundary floods. Of the 279 known IRBs, only 78 were represented by a transboundary rivers institution. A mere eight of the 153 identified institutions had transboundary flooding listed as an issue in their mandate. Overall, 43 basins, where transboundary floods were frequent during the period 1985-2005, had no institutional capacity for IRBs. The average death and displacement tolls were found to be lower in the 37 basins with institutional capacity, even though these basins experienced twice as much transboundary floods with significant higher magnitudes than those in basins without institutional capacity. Overall, the results suggested that institutional capacity plays a role in the reduction of flood-related casualties and affected individuals. River basins such as the Juba-Shibeli, Han, Kura-Araks, Ma, Maritsa, Po, Coco/Segovia, Grijalva, Artibonite, Changuinola, Coatan Achute, and Orinoco experienced more than one transboundary river flood, but have not yet set up any institutions for such events, or signed any appropriate treaties focused on floods. These basins were therefore recommended to consider focusing attention on this apparent lack of institutional capacity when it comes to managing transboundary flood events. [source] Continuous peripheral nerve block catheter tip adhesion in a rat modelACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2006C. C. Buckenmaier III Background:, Continuous peripheral nerve block (CPNB) has been used effectively in combat casualties from Iraq and Afghanistan to provide surgical anesthesia and extended duration analgesia during evacuation and convalescence. Little information is available concerning catheter tip tissue reaction with prolonged use. Methods:, Forty-eight male Sprague-Dawley rats were assigned (12 per group) to one of four catheter tip designs provided by Arrow International: group A, 20-gauge catheter with three side-holes and a bullet-shaped tip; group B, 19-gauge StimuCathÔ catheter with coiled omni-port end with hemispherical distal tip; group C, 19-gauge catheter with single end-hole in conducting tip; group D, 19-gauge catheter with closed conducting tip with four side-holes. Following laparotomy, a randomly assigned catheter tip was sutured to the parietal peritoneal wall with the tip extending between experimental injuries created on the abdominal wall and cecum. After 7 days in situ, the catheter tips were removed from the adhesion mass using a force gauge, and the grams of force needed for removal were recorded. Results:, The mean force ± standard deviation values were 1.09 ± 1.21 g for group A, 21.20 ± 30.15 g for group B, 0.88 ± 1.47 g for group C and 1.60 ± 2.50 g for group D. The variation of each catheter group mean force compared with that of group B was significant (P < 0.05). There was no significant difference in adhesion force between groups A, C and D. Conclusions:, These results suggest that the manufactured design of a CPNB catheter tip can contribute to the adhesion of the tip in an intense inflammatory environment. This finding may have important clinical implications for CPNB catheters left in place for extended periods of time. [source] Progress in type II dehydroquinase inhibitors: From concept to practiceMEDICINAL RESEARCH REVIEWS, Issue 2 2007Concepción González-Bello Abstract Scientists are concerned by an ever-increasing rise in bacterial resistance to antibiotics, particularly in diseases such as malaria, toxoplasmosis, tuberculosis, and pneumonia, where the currently used therapies become progressively less efficient. It is therefore necessary to develop new, safe, and more efficient antibiotics. Recently, the existence of the shikimic acid pathway has been demonstrated in certain parasites such as the malaria parasite. These types of parasites cause more than a million casualties per year, and their effects are particularly strong in people with a compromised immune system such as HIV patients. In such cases it is possible that inhibitors of this pathway could be active against a large variety of microorganisms responsible for the more opportunistic infections in HIV patients. Interest in this pathway has resulted in the development of a wide variety of inhibitors for the enzymes involved. This review covers recent progress made in the development of inhibitors of the third enzyme of this pathway, i.e., the type II dehydroquinase. The X-ray crystal structures of several dehydroquinases (Streptomyces coelicolor, Mycobacterium tuberculosis, etc.) with an inhibitor bound in the active site have recently been solved. These complexes identified a number of key interactions involved in inhibitor binding and have shed light on several aspects of the catalytic mechanism. These crystal structures have also proven to be a useful tool for the design of potent and selective enzyme inhibitors, a feature that will also be discussed. © 2006 Wiley Periodicals, Inc. Med Res Rev [source] Tropical storm impact in Central AmericaMETEOROLOGICAL APPLICATIONS, Issue 1 2006Sabino Palmieri Abstract In this study of tropical storm impacts in Central America, the relationship between physical variables (available in ,real time') and damage is explored, and a simple tool for early approximate evaluation of the impact is developed. Land track and energy dissipation appear as the most interesting parameters that modulate the hurricane impact. Because of the difficulty of attaching a monetary estimate to the damage caused in a large number of cases (as is required in a statistical approach), an ,Impact Index' based on the logarithm of casualties is introduced. Thereafter, within a subset of events in which damage in monetary terms is known, a rough link between damage and the Impact Index is derived. Shortly after a new event, as soon as land track and energy dissipation are known, either by means of an empirical equation or using a contour graph, the Impact Index may be determined. Another empirical equation allows a rough estimate of damage in monetary units, but because this estimate is based on a limited number of cases, it must be treated with caution. The methodology is tested for a small set of independent cases. Vulnerability to tropical cyclones depends not only on natural factors but also on sociopolitical conditions. A coupled sociological and environmental approach is believed to be the best way to improve the early impact estimate methodology. Copyright © 2006 Royal Meteorological Society. [source] The effect of crowd density on the expected number of casualties in a suicide attackNAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 1 2005Moshe Kress Abstract Utilizing elementary geometric and probability considerations, we estimate the effect of crowd blocking in suicide bombing events. It is shown that the effect is quite significant. Beyond a certain threshold, the expected number of casualties decreases with the number of people in the arena. The numerical results of our model are consistent with casualty data from suicide bombing events in Israel. Some operational insights are discussed. © 2004 Wiley Periodicals, Inc. Naval Research Logistics, 2005. [source] Risk factors for worker injury and death from occupational light vehicles crashes in New South Wales (Australia),AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010Rwth Stuckey MPH Abstract Background/Aim To identify risk and protective factors for crash casualty outcomes in occupational light vehicles (OLV), a previously under-recognized work context for injuries and fatalities. Methods A register-based study was conducted using linked vehicle crash and registration data (n,=,13,491) for the Australian state of New South Wales. Univariate and multivariate analyses were undertaken to assess the relationship between casualty outcomes and variables drawn from four domains of potential determinants of severity: user, vehicle, road, and work organization factors. Results Nineteen percent of OLV crashes had OLV-user casualties (n,=,2,506) and 1% fatalities (n,=,34). Adjusted casualty risk factors included tired driver (OR 2.1, 95% CI 1.5,2.7), no seat belt use (OR 1.8, 95% CI 1.4,2.3), and excessive speed (OR 1.4, 95% CI 1.2,1.6). Adjusted fatality risk factors were no seat belt (OR 12.9, 95% CI 4.9,34.3) and high-speed zone crash (OR 5.0, 95% CI 2.1,12.3). Conclusions OLV users are at risk from both recognized road risks and hazards specific to OLV use. Findings suggest that risk reduction could be improved by the use of safer vehicles, fatigue management, and journey planning. Am. J. Ind. Med. 53:931,939, 2010. © 2010 Wiley-Liss, Inc. [source] Changes in Diagnostic Criteria for PTSD: Implications From Two Prospective Longitudinal StudiesAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2007Zahava Solomon PhD This study assesses differences in PTSD rates according to different sets of diagnostic criteria. Two samples have been studied: one comprised of 286 combat stress reaction (CSR) casualties and 218 non-CSR veterans from the Lebanon war (Study 1); the other of 95 ex-POWs and 101 non-POWs from the Yom Kipur war (Study 2). Participants were administered two versions of the PTSD inventory based on different Diagnostic and Statistical Manual of Mental Disorders (DSM) editions: DSM-III and DSM-IV in Study 1 and DSM-III-R and DSM-IV in Study 2. PTSD rates declined when criteria of more recent DSM editions were applied. In addition, findings clearly demonstrate the importance of the dysfunction criterion (F) in PTSD. The highly complex nature of the PTSD diagnosis is discussed, as well as the important role of dysfunction and distress. [source] Factors for consideration in developing a plan to cope with mass burn casualtiesANZ JOURNAL OF SURGERY, Issue 9 2009BSc(Hons), FRACS, FRCS(Eng), FRCS(Plast), John E Greenwood AM, MBChB No abstract is available for this article. [source] Radiative cooling effect of Hurricane Florence in 2006 and precipitation of Typhoon Matsa in 2005ATMOSPHERIC SCIENCE LETTERS, Issue 2 2009Quanhua Liu Abstract The increasing strength of tropical cyclones may be a response of the Earth's interaction between natural variability and human activities. Negative effects of the severe storms, such as flooding, landslides, damage to properties, and even a number of human casualties, have been reported many times. This study reported other aspects on Hurricanes and Typhoons, which may be beneficial to the world. We found that Hurricane Florence in 2006 decreased radiation energy by , 0.5 × 1020 J to the Earth-atmospheric system, about 10% of the annual global energy consumption. If the amount of energy uniformly distributes over the whole Earth surface and over 1-year time, it corresponds to a power of , 0.003 W m,2 The total forcing power on climate change is 0.24 W m,2, if we only take account for the stored fluxes in water, atmosphere, continents, and heat required to melt glaciers and sea ice. Thus, the shielding effect of solar radiation by tropical storms could contribute to ease global warming. In addition, hurricane and typhoon can ease drought sometimes. This study found that the total rainwater carried by Typhoon Matsa in August 2005 into China's inland amounts to about 135 billion tons. The rainfall over the northern China eased severe drought in summer 2005. Copyright © 2009 Royal Meteorological Society [source] Spatial ecology of a threatened python (Morelia spilota imbricata) and the effects of anthropogenic habitat changeAUSTRAL ECOLOGY, Issue 3 2005D. PEARSON Abstract Large predators play important ecological roles, but often are sensitive to habitat changes and thus are early casualties of habitat perturbation. Pythons are among the largest predators in many Australian environments, and hence warrant conservation-orientated research. Carpet pythons (Morelia spilota imbricata) have declined across much of south-western Australia presumably because of habitat clearance and degradation. Information on habitat use, home range sizes and movements is needed to plan for the conservation of this important predator. We studied pythons at two study sites (Garden Island and Dryandra Woodland) with markedly different climates, habitat types and disturbance histories. We surgically implanted radio-transmitters in 91 pythons and tracked them for periods of 1 month to 4 years. Dryandra pythons remained inactive inside tree hollows during cooler months (May,September), whereas some (especially small) pythons on Garden Island continued to move and feed. Overall weekly displacements (mean = 100,150 m) were similar at the two study sites and among sex/age classes, except that reproductive females were sedentary during summer while they were incubating eggs. Home ranges averaged 15,20 ha. Adult male pythons had larger home ranges than adult females at Dryandra, but not at Garden Island. Radio-tracked snakes at Dryandra exhibited high site fidelity, returning to previously occupied logs after long absences and reusing tree hollows for winter shelter. Many of the logs used by snakes had been felled during plantation establishment >70 years ago, with little subsequent regeneration of source trees. In contrast, Garden Island snakes usually sheltered under dense shrubs. Habitat usage was similar among different sex/age classes of snakes at each site, except that juvenile pythons were more arboreal than adults. Although carpet pythons demonstrate great flexibility in habitat use, certain habitat elements appear critical for the persistence of viable populations. Fire plays a central role in this process, albeit in complex ways. For example, low-intensity fires reduce the availability of hollow logs on the ground at Dryandra and fail to regenerate shrub thickets required by prey species. Paradoxically, high-intensity fires stimulate shrub thickets and fell trees creating new logs , but might also threaten overwinter trees. Thus, the impact of disturbances (such as wildfires) on the viability of python populations will be mediated in complex ways by alteration to important microhabitats such as vegetation cover or log availability. At Dryandra, landscape management should include occasional fire events to generate new logs as well as shrub thickets used by prey. Strategic burning may also be required at Garden Island to regenerate some vegetation communities. [source] Teaching Mass Casualty Triage Skills Using Immersive Three-dimensional Virtual RealityACADEMIC EMERGENCY MEDICINE, Issue 11 2008Dale S. Vincent MD Abstract Objectives:, Virtual reality (VR) environments offer potential advantages over traditional paper methods, manikin simulation, and live drills for mass casualty training and assessment. The authors measured the acquisition of triage skills by novice learners after exposing them to three sequential scenarios (A, B, and C) of five simulated patients each in a fully immersed three-dimensional VR environment. The hypothesis was that learners would improve in speed, accuracy, and self-efficacy. Methods:, Twenty-four medical students were taught principles of mass casualty triage using three short podcasts, followed by an immersive VR exercise in which learners donned a head-mounted display (HMD) and three motion tracking sensors, one for their head and one for each hand. They used a gesture-based command system to interact with multiple VR casualties. For triage score, one point was awarded for each correctly identified main problem, required intervention, and triage category. For intervention score, one point was awarded for each correct VR intervention. Scores were analyzed using one-way analysis of variance (ANOVA) for each student. Before and after surveys were used to measure self-efficacy and reaction to the training. Results:, Four students were excluded from analysis due to participation in a recent triage research program. Results from 20 students were analyzed. Triage scores and intervention scores improved significantly during Scenario B (p < 0.001). Time to complete each scenario decreased significantly from A (8:10 minutes) to B (5:14 minutes; p < 0.001) and from B to C (3:58 minutes; p < 0.001). Self-efficacy improved significantly in the areas of prioritizing treatment, prioritizing resources, identifying high-risk patients, and beliefs about learning to be an effective first responder. Conclusions:, Novice learners demonstrated improved triage and intervention scores, speed, and self-efficacy during an iterative, fully immersed VR triage experience. [source] Alteration of inflammatory response following small-volume resuscitationBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2000F. Gebhard Background Small-volume resuscitation is rather effective in the primary volume treatment of major trauma. Blood pressure stabilizing effects occur immediately but last for a limited period only. Influences on inflammatory reactions in humans have not been reported so far. This prospective randomized study therefore analysed the inflammatory response in the very early (pre)clinical period after administration of crystalloids plus starch, hyperosmolar/hyperoncotic starch and lyophilized plasma solutions. Methods Upon approval of the ethics committee, 41 patients were enrolled with multiple injuries (injury severity score (ISS) mean 34 (range 9,75)). The patients received randomly either standard solutions, i.e. starch plus crystalloids (group C (control); n = 14), hyperosmolar/hyperoncotic starch (group S (small volume); n = 14) or lyophilized plasma (group L (lyoplasma); n = 13). Subsets were performed according to the different solutions as well as to the severity of trauma (ISS below 17, 18,31, 32 or more) and survivors/non-survivors. The first blood sample was obtained at the scene of the accident before cardiopulmonary resuscitation, when appropriate. Subsequently, blood samples were collected hourly. All samples were spun immediately at 4°C and stored at ,70°C. Interleukin (IL) 6 as well as several different prostaglandins (PGI2, thromboxane A2, PGE2) were determined to characterize the overall inflammatory response. Results Eleven casualties (seven men and four women, mean age 31 years) died because of major trauma within 24 h after the incident. In all patients IL-6 levels promptly increased within the first 2 h, most pronounced in patients with the severest trauma (ISS greater than 32) and non-survivors. Patients in groups C and S had a comparable time course of IL-6 plasma levels with a slightly higher release in minor injuries (ISS less than 30). The same was true for prostaglandins. In contrast, patients in group L had clearly higher IL-6 concentrations during the first 2,12 h, again most pronounced in those with the severest trauma (ISS greater than 32). Conclusion These results demonstrate that the early systemic inflammatory response after small-volume resuscitation is rather similar to that of patients infused with standard-volume therapy after trauma. In contrast, lyoplasma seems to increase the inflammatory response regardless of the injury severity. © 2000 British Journal of Surgery Society Ltd [source] | |||||||||||||||||||||||||||||||||||||