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Evacuation
Kinds of Evacuation Selected AbstractsCommunity Resilience and Volcano Hazard: The Eruption of Tungurahua and Evacuation of the Faldas in EcuadorDISASTERS, Issue 1 2002Graham A. Tobin Official response to explosive volcano hazards usually involves evacuation of local inhabitants to safe shelters. Enforcement is often difficult and problems can be exacerbated when major eruptions do not ensue. Families are deprived of livelihoods and pressure to return to hazardous areas builds. Concomitantly, prevailing socioeconomic and political conditions limit activities and can influence vulnerability. This paper addresses these issues, examining an ongoing volcano hazard (Tungurahua) in Ecuador where contextual realities significantly constrain responses. Fieldwork involved interviewing government officials, selecting focus groups and conducting surveys of evacuees in four locations: a temporary shelter, a permanent resettlement, with returnees and with a control group. Differences in perceptions of risk and health conditions, and in the potential for economic recovery were found among groups with different evacuation experiences. The long-term goal is to develop a model of community resilience in long-term stress environments. [source] Evacuation of pelleted feed and the suitability of titanium(IV) oxide as a feed marker for gut kinetics in Nile tilapiaJOURNAL OF FISH BIOLOGY, Issue 5 2003H. Richter The present study assessed the suitability of titanium(IV) oxide, TiO2, as a digesta passage marker in Nile tilapia Oreochromis niloticus and studied the shape of the evacuation curve in this species. In three separate trials, fish were given one dose of either 0·5, 0·25 or 0·1% of their body mass (% BME) of feed marked with 1% TiO2 or 0·5% BME of the same feed without marker. The fish were serially slaughtered at intervals after feeding and the stomach contents analysed for dry mass and marker content. The data for individual trials were analysed with the linear, square root, surface area and exponential evacuation models and parameter comparisons showed that, although the marker interfered slightly with the evacuation process, true meal size could be predicted more accurately from the marker data. The results of an analysis of the combined data sets suggested that stomach evacuation in this species is dependent more on food particle surface area (surface area model) than on stomach content mass (exponential model) as is generally assumed. On the basis of these results, it was concluded that TiO2 at an inclusion level of 1% is an acceptable marker for quantifying evacuation with a view to predicting food consumption but should be used with caution in digestibility studies. [source] Emergency Air Evacuation of Critically Ill Patients from Cruise ShipsJOURNAL OF TRAVEL MEDICINE, Issue 6 2002John A. Knowles MD No abstract is available for this article. [source] Evaluation of Emergency Air Evacuation of Critically Ill Patients from Cruise ShipsJOURNAL OF TRAVEL MEDICINE, Issue 6 2001Laurence D. Prina Background: The study objectives were to assess the ship physician's diagnostic accuracy in making the decision to air evacuate critically ill patients from cruise ships, to determine the outcome of these patients, and the overall benefit of air evacuation. Methods: From October 1999 to May 2000, we performed a prospective study of critically ill patients coming from cruise ships in the Caribbean and transported to our institution by air ambulance. Demographics, initial diagnosis, and treatment on board were collected by the triage officer at the time of the cruise physician's first call. In route complications and flight team composition were obtained from the air ambulance monitoring log. Patients were followed-up in the hospital for complications, outcome, and final diagnosis. Results: A consecutive series of 104 patients were considered for analysis. There were 65 men and 39 women (mean age: 68.7 years). Cruise physician's diagnosis was correct in more than 90% of the cases. Internal medicine and surgical conditions represented 80.8% and 19.2% of the cases respectively, falling mainly into three categories: cardiac (34.6%), neurological (20.2%), and digestive (14%). Two cardiac arrests and 1 ventricular fibrillation were successfully resuscitated and 5 of 15 myocardial infarctions received thrombolytic therapy on board. Air transfers were warranted in 96.1% of the cases and physician presence in the flight was considered appropriate in 97.6%. In route complications and mortality rate were 5.8% and 2.9% respectively, related to serious cardiac events. Among the 98 hospitalized patients, 10 patients developed new complications and 5 died. The overall mortality rate was 7.7%. Conclusion: The cruise industry appears off to a good start in the medical treatment of passengers needing air evacuation to a land based medical facility. There is room for improvement and adoption of American College of Emergency Physicians (ACEP) and International Council of Cruise Lines (ICCL) Health Care Guidelines are meaningful first steps. Analysis of Caribbean medical facilities and implementation of active telemedicine conferencing represent alternatives to air evacuation that need to be studied. [source] Does Political Ideology Moderate Stress: The Special Case of Soldiers Conducting Forced EvacuationAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2007Tomer Shechner MA This study examined the moderating role of political ideology on psychological outcomes for Israeli soldiers participating in the forced evacuation of Jewish settlements from Gaza. Change in psychopathology and well-being was assessed for 3 concurrent mission groups differing in their political ideological contentiousness,forced evacuation, Gaza security, and Northern border security. After soldiers in each mission group were classified on the basis of relatively left- or right-wing political ideological tendencies, the authors examined differential impact of each mission on soldiers of differing political ideology. Results confirmed strong moderation effects of political ideology on psychological outcomes in these extreme contexts. Implications for research, prevention, and treatment are discussed. [source] Incrementalism before the Storm: Network Performance for the Evacuation of New OrleansPUBLIC ADMINISTRATION REVIEW, Issue 2006John J. Kiefer Hurricane Katrina revealed a lack of preparedness in disaster management networks covering the New Orleans area. This paper focuses on the operation of networks in preparing to evacuate residents in advance of a major disaster. There are two cases: the relatively successful evacuation of residents who left by private conveyance and the widely publicized failure to provide for those who could not or would not leave on their own. We trace the actions and inactions of various players to reach conclusions about the strengths and weaknesses of networks in the special circumstances of disaster preparation. [source] Outcomes of Heimlich valve drainage in dogsAUSTRALIAN VETERINARY JOURNAL, Issue 4 2009H Salci Objective and design Retrospective study of the outcomes of Heimlich valve drainage in dogs. Procedure Medical records of the past 3 years were retrospectively reviewed. Heimlich valve drainage was used in 34 dogs (median body weight 30 ± 5 kg): lobectomy (n = 15), pneumonectomy (n = 9), intrathoracic oesophageal surgery (n = 2), diaphragmatic hernia repair (n = 1), traumatic open pneumothorax (n = 2), bilobectomy (n = 2), ligation of the thoracic duct (n = 1), and chylothorax and pneumothorax (n = 1 each). Evacuation of air and/or fluid from the pleural cavity was performed with the Heimlich valve following thoracostomy tube insertion. During drainage, the dogs were closely monitored for possible respiratory failure. Termination of Heimlich valve drainage was controlled with underwater seal drainage and assessed with thoracic radiography. Results Negative intrathoracic pressure was provided in 29 dogs without any complications. Post pneumonectomy respiratory syncope and post lobectomy massive hemothorax, which did not originate from the Heimlich valve, were the only postoperative complications. Dysfunction of the valve diaphragm, open pneumothorax and intrathoracic localisation of an acute gastric dilatation,volvulus syndrome caused by a left-sided diaphragmatic hernia following pneumonectomy were the Heimlich valve drainage complications. Conclusions The Heimlich valve can be used as a continuous drainage device in dogs, but the complications reported here should be considered by veterinary practitioners. [source] Influence of the atmosphere on the growth of LiYF4 single crystal fibers by the micro-pulling-down methodCRYSTAL RESEARCH AND TECHNOLOGY, Issue 2 2009D. Maier Abstract Micro-pulling-down growth of LiYF4 single crystal fibers have been performed under different gas atmospheres using stoichiometric LiYF4 single crystal pieces from prior Czochralski experiments as starting material. Completely transparent and phase pure LiYF4 single crystal fibers could be obtained after evacuation of the recipient to 2×10 -6 mbar and subsequent filling with pure (99.995%) CF4 gas. Using a gas mixture of 5% CF4 in Argon or pure 5N Argon leads to the formation of micro crystallites of oxofluorides on the surface. Evacuating only to 3 × 10 -3 mbar leads, independently of atmosphere, to completely white fibers that are heavily contaminated with oxofluorides. DSC measurements of the completely transparent fiber grown under pure CF4 atmosphere reveal congruent melting behavior. (© 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] The significance of a small, level-3 ,semi evacuation' hospital in a terrorist attack in a nearby townDISASTERS, Issue 3 2007Moshe Pinkert 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. [source] Natural disasters and older US adults with disabilities: implications for evacuationDISASTERS, Issue 1 2007Lisa C. McGuire PhD We analysed 2003 and 2004 Behavioral Risk Factor Surveillance System (BRFSS) data from New Orleans-Metairie-Kenner, LA to produce estimates of the number of community dwelling people aged 65 years or older with a disability and requiring special equipment., Approximately, 47,840 (31.6 per cent) older adults with a disability and 24,938 (16.6 per cent) older adults requiring the use of special equipment were community dwelling and might require assistance to evacuate or a shelter that could accommodate special equipment. Older adults who need special equipment were likely to be female, unmarried and white, and to rate their health as fair or poor. Personnel who plan and prepare for evacuations and temporary shelter during disasters need baseline information on the number of older adults with a disability or who require special equipment. A surveillance system, such as the BRFSS, gathers information that planners can use to prepare for and to deliver services. [source] Community Resilience and Volcano Hazard: The Eruption of Tungurahua and Evacuation of the Faldas in EcuadorDISASTERS, Issue 1 2002Graham A. Tobin Official response to explosive volcano hazards usually involves evacuation of local inhabitants to safe shelters. Enforcement is often difficult and problems can be exacerbated when major eruptions do not ensue. Families are deprived of livelihoods and pressure to return to hazardous areas builds. Concomitantly, prevailing socioeconomic and political conditions limit activities and can influence vulnerability. This paper addresses these issues, examining an ongoing volcano hazard (Tungurahua) in Ecuador where contextual realities significantly constrain responses. Fieldwork involved interviewing government officials, selecting focus groups and conducting surveys of evacuees in four locations: a temporary shelter, a permanent resettlement, with returnees and with a control group. Differences in perceptions of risk and health conditions, and in the potential for economic recovery were found among groups with different evacuation experiences. The long-term goal is to develop a model of community resilience in long-term stress environments. [source] Expected loss-based alarm threshold set for earthquake early warning systemsEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 9 2007Iunio Iervolino Abstract Earthquake early warning systems (EEWS) seem to have potential as tools for real-time seismic risk management and mitigation. In fact, although the evacuation of buildings requires warning time not available in many urbanized areas threatened by seismic hazard, they may still be used for the real-time protection of critical facilities using automatic systems in order to reduce the losses subsequent to a catastrophic event. This is possible due to the real-time seismology, which consists of methods and procedures for the rapid estimation of earthquake features, as magnitude and location, based on measurements made on the first seconds of the P -waves. An earthquake engineering application of earthquake early warning (EEW) may be intended as a system able to issue the alarm, if some recorded parameter exceeds a given threshold, to activate risk mitigation actions before the quake strikes at a site of interest. Feasibility analysis and design of such EEWS require the assessment of the expected loss reduction due to the security action and set of the alarm threshold. In this paper a procedure to carry out these tasks in the performance-based earthquake engineering probabilistic framework is proposed. A merely illustrative example refers to a simple structure assumed to be a classroom. Structural damage and non-structural collapses are considered; the security action is to shelter occupants below the desks. The cost due to a false alarm is assumed to be related to the interruption of didactic activities. Results show how the comparison of the expected losses, for the alarm-issuance and non-issuance cases, allows setting the alarm threshold on a quantitative and consistent basis, and how it may be a tool for the design of engineering applications of EEW. Copyright © 2007 John Wiley & Sons, Ltd. [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] The introduction of social adaptation within evacuation modellingFIRE AND MATERIALS, Issue 4 2006S. Gwynne Abstract In recent history, a number of tragic events have borne a consistent message; the social structures that existed prior to and during the evacuation significantly affected the decisions made and the actions adopted by the evacuating population in response to the emergency. This type of influence over behaviour has long been neglected in the modelling community. This paper is an attempt to introduce some of these considerations into evacuation models and to demonstrate their impact. To represent this type of behaviour within evacuation models a mechanism to represent the membership and position within social hierarchies is established. In addition, individuals within the social groupings are given the capacity to communicate relevant pieces of data such as the need to evacuate,impacting the response time,and the location of viable exits,impacting route selection. Furthermore, the perception and response to this information is also affected by the social circumstances in which individuals find themselves. Copyright © 2005 John Wiley & Sons, Ltd. [source] Controversies in the laparoscopic treatment of hepatic hydatid diseaseHPB, Issue 4 2004Koray Acarli Background Laparoscopic treatment of hydatid disease of the liver can be performed safely in selected patients. Methods Six hundred and fifty patients were treated for hydatid disease of the liver between 1980 and 2003 at the Hepatopancreato-biliary Surgery Unit of Istanbul Medical Faculty, Istanbul University. Of these, 60 were treated laparoscopically between 1992 and 2000. A special aspirator-grinder apparatus was used for the evacuation of cyst contents. Ninety-two percent of the cysts were at stages I, II or III according to the ultrasonographic classification of Gharbi. Results Conversion to open surgery was necessary in eight patients due to intra-abdominal adhesions or cysts in difficult locations. There was no disease- or procedure-related mortality. Most of the complications were related to cavity infections (13.5%) and external biliary fistulas (I 1.5%) resulting from communications between the cysts and the biliary tree. There were two recurrences in a follow-up period ranging between 3.5 and I I years. Discussion Laparoscopic treatment of hydatid disease of the liver is an alternative to open surgery in well-selected patients. Important steps are the evacuation of the cyst contents without spillage, sterilization of the cyst cavity with scolicidal agents and cavity management using classical surgical techniques. Our specially designed aspirator-grinder apparatus was safely used to evacuate the cyst contents without causing any spillage. Knowledge of the relationship of the cyst with the biliary tree is essential in choosing the appropriate patients for the laparoscopic technique. In our experience of 650 cases, the biliary communication rate was as high as 18%; half of these can be detected preoperatively. In the remaining, biliary communications are usually detected during or after surgery. Endoscopie retrograde cholangiopancreatography (ERCP) and sphincterotomy are helpful to overcome this problem. As hydatid disease of the liver is a benign and potentially recurrent disease, we advocate the use of conservative techniques in both laparoscopic and open operations. [source] Suspended sediment transport regime in a debris-flow gully on Vancouver Island, British ColumbiaHYDROLOGICAL PROCESSES, Issue 4 2005Craig J. Nistor Abstract In debris-flow-prone channels, normal fluvial sediment transport occurs (nearly exclusively in suspended mode) between episodic debris-flow events. Observations of suspended sediment transport through a winter season in a steepland gully in logged terrain revealed two event types. When flows exceeded a threshold of 270 l s,1, events yielded significant quantities of sediment and suspended sediment concentration increased with flow. Smaller events were strongly ,supply limited'; sediment concentration decreased as flow increased. Overall, there is no consistent correlation between runoff and sediment yield. Within the season, three subseasons were identified (demarcated by periods of freezing weather) within which a pattern of fine sediment replenishment and evacuation occurred. Finally, a signature of fine sediment mobilization and exhaustion was observed within individual events. Fine sediment transport occurred in discrete pulses within storm periods, most of the yield occurring within 5 to 15% of storm runoff duration, so that it is unlikely that scheduled sampling programs would identify significant transport. Significant events are, however, generally forecastable on the basis of regional heavy rainfall warnings, providing a basis for targeted observations. Radiative snowmelt events and rain-on-snow remain difficult to forecast, since the projection of temperatures from the nearest regular weather station yields variable results. Copyright © 2004 John Wiley & Sons, Ltd. [source] Fluid regimens for colostomy irrigation: a systematic reviewINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2008Lucylynn Lizarondo Abstract Background, Various techniques for managing faecal evacuation have been proposed; however, colostomy irrigation is favoured as it leads to better patient outcomes. Alternative fluid regimens for colostomy irrigation have been suggested to achieve effective evacuation. Aim, The objective of this review was to summarise the best available evidence on the most effective fluid regimen for colostomy irrigation. Search strategy, Trials were identified by electronic searches of CINAHL, PubMed, MEDLINE, Current Contents, the Cochrane Library and EMBASE. Unpublished articles and references lists from included studies were also searched. Selection criteria, Randomised controlled trials and before-and-after studies investigating any fluid regimen for colostomy irrigation were eligible for inclusion. Outcomes measured included fluid inflow time, total wash-out time, haemodynamic changes during irrigation, cramps, leakage episodes, quality of life and level of satisfaction. Data collection and analysis, Trial selection, quality appraisal and data extraction were carried out independently by two reviewers. Differences in opinion were resolved by discussion. Main results, The systematic literature search strategy identified two cross-over trials that compared water with another fluid regimen. Owing to the differences in irrigating solutions used, the results were not pooled for analysis. Both the polyethylene glycol electrolyte solution and glyceryl trinitrate performed significantly better than water. Conclusion, There is some evidence to support the effectiveness of fluid regimens other than water, such as polyethylene glycol electrolyte and glyceryl trinitrate, for colostomy irrigation. Further well-designed clinical trials are required to establish solid evidence on the effectiveness of other irrigating solutions that might enhance colonic irrigation. [source] Immobilization of MacMillan Imidazolidinone as Mac-SILC and its Catalytic Performance on Sustainable Enantioselective Diels,Alder CycloadditionADVANCED SYNTHESIS & CATALYSIS (PREVIOUSLY: JOURNAL FUER PRAKTISCHE CHEMIE), Issue 5 2010Hisahiro Hagiwara Abstract MacMillan's imidazolidinone catalyst was immobilized as a supported ionic liquid catalyst (Mac-SILC) in the pores of silica gel with the aid of an ionic liquid , 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide. The heterogenized organocatalyst was utilized for the enantioselective Diels,Alder reaction of cyclopentadiene and cinnamaldehyde, recovered by simple filtration and subsequent evacuation, and repeatedly used up to six times in 81% average chemical yield, 87% ee for endo - and 80% ee for exo -products. The Mac-SILC was effective for a variety of substrates. [source] The role of SeprafilmÔ bioresorbable membrane in the prevention and therapy of endometrial synechiaeJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2002Vassilios S. Tsapanos Abstract This randomized controlled blind prospective study is undertaken to evaluate the safety and efficacy of SeprafilmÔ,a novel bioresorbable membrane of chemically modified hyaluronic acid and carboxymethylcellulose,in prevention and reduction of postoperative endometrial and endocervical synechiae formation after general suction evacuation or curettage for incomplete, missed, and recurrent abortion. In total, 150 patients with incomplete or missed abortion participated in the clinical study. The study population was divided into two main groups. In the treatment (SeprafilmÔ) group (n=50), application of SeprafilmÔ membrane in the endometrial cavity and the cervical canal was used after the suction evacuation and/or the curettage. In the control group (n=100), nothing was inserted in the uterus. Both groups were divided into two subgroups: patients who had no previous suction or curettage, (with no previous D&C) (n=88), and patients who had at least one previous suction or curettage (with one or more previous D&C) (n=62). In the treatment (SeprafilmÔ) group, 32 patients had no previous D&C and 18 patients had one or more previous D&C. In the control group, 56 patients had no previous D&C and 44 patients had one or more previous D&C. Further fertility was estimated by pregnancy success in all groups. Endometrial synechiae formation was evaluated with the use of hysterosalpingography (HSG) in patients of all groups without pregnancy success 8 months after the intervention. Registering any adverse reaction and performing ultrasound controls assessed the safety of SeprafilmÔ use. From the subgroup with no previous D&C, all 32 patients (100%) who received SeprafilmÔ had a pregnancy in the following 8 months; in the controls, pregnancy occurred only in 54%. It was also demonstrated with hysterosalpingography (HSG) that patients with one or more previous interventions and no pregnancy 8 months later were adhesion free in 90% of the patients where SeprafilmÔ was used, and only 50% in the untreated group. The membrane was tested on the endometrial area of the uterus and did not produce any adverse reaction. Ultrasound controls did not show any abnormal echoes. Intrauterine insertion of SeprafilmÔ is safe, prevents the appearance of endocervical adhesions or endometrial synechiae after curettage, and reduces the area of the endometrial cavity occupied by them in a large percent of cases. It also seems that its use improves the possibility of a new pregnancy and fertility. © 2001 Wiley Periodicals, Inc. J Biomed Mater Res (Appl Biomater) 63: 10,14, 2002 [source] Does gestational sac volume predict the outcome of missed miscarriage managed expectantly?JOURNAL OF CLINICAL ULTRASOUND, Issue 9 2002Ganesh Acharya MD Abstract Purpose The aim of this study was to investigate whether gestational sac volume (GSV) can predict the outcome of missed miscarriages that are managed expectantly. Methods This was a prospective observational study. Between February 1, 2000, and January 31, 2001, all patients with a confirmed first-trimester missed miscarriage who chose to undergo expectant management were recruited to participate. A single investigator performed all sonographic examinations and measurements. The main outcome measure was a complete spontaneous abortion within 4 weeks of the initial diagnosis. A complete miscarriage was defined as a maximum anteroposterior diameter of the endometrium of less than 15 mm on transvaginal sonography and no persistent heavy vaginal bleeding. The patients could opt to undergo surgery at any time, but those who had not expelled the products of conception within 4 weeks of the diagnosis were advised to have surgical uterine evacuation. Results In total, 90 patients were enrolled, and 86 patients completed the study. The mean GSV, as measured by 3-dimensional sonography, was 9.7 ± 8.9 ml, and the mean sac diameter was 24.5 ± 8.0 mm. A significant exponential correlation was found between the mean sac diameter and the GSV (r = 0.86; p < 0.0001). Forty-six (53.5%) of the 86 patients experienced a complete miscarriage within 4 weeks of the diagnosis (ie, expectant management was successful), but expectant management was unsuccessful in the remaining 40 (46.5%) patients (5 had an incomplete miscarriage, and 35 did not expel the products of conception). The GSV did not differ significantly between the "successful" and "unsuccessful" groups (p = 0.82). A logistic regression analysis showed no significant correlation between GSV and the outcome of missed miscarriages managed expectantly (p = 0.59). Conclusions The GSV does not predict the outcome of expectant management of missed miscarriage within 4 weeks of the diagnosis. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30: 526,531, 2002; Published online in Wiley InterScience (www. interscience.wiley.com). DOI: 10.1002/jcu.10107 [source] Incident Command System as a Response Model Within Emergency Operation Centers during Hurricane RitaJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 3 2008Leslie D. Lutz This study examines the degree to which the use of the Incident Command System (ICS) influenced the performance of Texas emergency operations centers (EOCs) during Hurricane Rita. Staff in evacuation, transition, and host county EOCs completed a questionnaire that assessed demographic variables, EOC physical environment, ICS experience, ICS implementation, and team climate. The results indicated that the duties each ICS section performed varied substantially from one EOC to another. Moreover, ICS experience and ICS implementation lacked statistically significant correlations with team climate, even though EOCs' physical environments did. Finally, staff from emergency relevant agencies (e.g., public works and social services) seemed to have more problems with ICS than did staff from emergency mission agencies (e.g., fire and police departments). Thus, there needs to be further study of ICS application in emergencies other than structural and wildland fires, as well as the development of new ICS training materials for emergency relevant agencies to supplement the current ICS training materials for emergency mission agencies. [source] Multicenter randomized controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrheaJOURNAL OF DIGESTIVE DISEASES, Issue 4 2002Shu Dong XIAO OBJECTIVE: Chronic diarrhea is a common bowel disorder, and disturbance of intestinal microorganisms may play a role in its pathogenesis. The aim of this study was to assess the clinical efficacy of lyophilized heat-killed Lactobacillus acidophilus LB compared with living lactobacilli in the treatment of chronic diarrhea. METHODS: One hundred and thirty-seven patients with chronic diarrhea were randomly allocated to receive either a 4-week course of two capsules of Lacteol Fort twice a day as the Lacteol group (69 patients completed the course) or a 4-week course of five chewable tablets of Lacidophilin three times a day as the Lacidophilin group (64 patients completed the course). The frequency of stools was recorded quantitatively and the semiquantitative parameters such as stool consistency, abdominal pain, distension and feeling of incomplete evacuation were evaluated. RESULTS: At the second and fourth week of the treatment, the mean bowel frequency was significantly lower in the Lacteol group than in the Lacidophilin group (1.88 ± 1.24 vs 2.64 ± 1.12, 1.39 ± 0.92 vs 2.19 ± 1.05, respectively; P < 0.05). At the end of the treatment, the clinical symptoms were markedly improved in the Lacteol group. CONCLUSIONS: Lactobacillus acidophilus LB is more effective than living lactobacilli in the treatment of chronic diarrhea. [source] A comparison of gut evacuation models for larval mackerel (Scomber scombrus) using serial photographyJOURNAL OF FISH BIOLOGY, Issue 4 2009R. Dunbrack A novel technique is described, using serial photography of the gut contents of transparent living larval fishes, to generate individual gut evacuation time series. This technique was applied to Atlantic mackerel Scomber scombrus larvae to compare three widely used models of gut evacuation: linear, exponential and square-root. Regression r2 for the exponential model exceeded those for the linear and square root models in 20 of 21 time series, strongly supporting the exponential model. At the initial gut fullness for each time series, total gut evacuation rates calculated with the exponential model averaged 2·2 and 1·3 times greater than those calculated with the linear and square-root models, respectively, and would produce correspondingly higher estimates of feeding rates for field-collected larvae with similar levels of gut fullness. The results highlight the importance of choosing the appropriate evacuation model in feeding studies, particularly those intended to examine short-term changes in larval fish feeding rates, a contributing factor to the highly variable yearly recruitment of many marine fish species. [source] Effect of sampling interval and temperature on the accuracy of food consumption estimates from stomach contentsJOURNAL OF FISH BIOLOGY, Issue 1 2005A. G. Finstad The effect of temperature and sampling interval on the accuracy of food consumption estimates based on stomach contents was studied using simulation. Three temporal patterns of feeding were considered (scattered throughout the day, one 5 h period or two 5 h periods) and gastric evacuation was modelled according to published values. Sampling intervals of 3 h gave reasonable food consumption estimates (2 to 19% error) at all temperatures. Comparably, sampling intervals as large as 12 h gave reasonable estimates of food consumption (1 to 20% error) when temperature was set to ,10° C. At temperatures <5° C, even 24 h intervals (equivalent to one daily sampling) provided reasonable estimates of daily food consumption (2 to 19% error) for all but the highest gastric evacuation rate combined with one daily feeding period (47% error). The temperature effect on estimation error resulted from diminishing temporal fluctuations in stomach contents with slower gastric evacuation rates. It follows that sampling effort may be considerably minimized when estimating food consumption from stomach contents during periods with low temperatures such as the winter time experienced by temperate fishes. [source] Evacuation of pelleted feed and the suitability of titanium(IV) oxide as a feed marker for gut kinetics in Nile tilapiaJOURNAL OF FISH BIOLOGY, Issue 5 2003H. Richter The present study assessed the suitability of titanium(IV) oxide, TiO2, as a digesta passage marker in Nile tilapia Oreochromis niloticus and studied the shape of the evacuation curve in this species. In three separate trials, fish were given one dose of either 0·5, 0·25 or 0·1% of their body mass (% BME) of feed marked with 1% TiO2 or 0·5% BME of the same feed without marker. The fish were serially slaughtered at intervals after feeding and the stomach contents analysed for dry mass and marker content. The data for individual trials were analysed with the linear, square root, surface area and exponential evacuation models and parameter comparisons showed that, although the marker interfered slightly with the evacuation process, true meal size could be predicted more accurately from the marker data. The results of an analysis of the combined data sets suggested that stomach evacuation in this species is dependent more on food particle surface area (surface area model) than on stomach content mass (exponential model) as is generally assumed. On the basis of these results, it was concluded that TiO2 at an inclusion level of 1% is an acceptable marker for quantifying evacuation with a view to predicting food consumption but should be used with caution in digestibility studies. [source] Development and physiology of gastric dilation air sacculitis in Chinook salmon, Oncorhynchus tshawytscha (Walbaum)JOURNAL OF FISH DISEASES, Issue 8 2007L G Forgan Abstract The syndrome known as gastric dilation air sacculitis (GDAS) has previously been shown to affect Chinook salmon, Oncorhynchus tshawytscha, in seawater (SW) aquaculture. Feed and osmoregulatory stress have been implicated as potential epidemiological co-factors. The development and physiology of GDAS was investigated in SW and freshwater (FW) adapted smolts. Diet A (low-cohesion pellets) and diet B (high-cohesion pellets) were fed to both FW- and SW-adapted fish. GDAS was induced only in the SW trial on feeding diet A. Stimulated gastro-intestinal (GI) smooth muscle contractility, and fluid transport by the pyloric caeca were different in GDAS-affected fish, which also showed osmoregulatory dysfunction. Cardiac stomach (CS) smooth muscle contractility in response to acetylcholine and potassium chloride (KCl) was significantly reduced in fish fed diet A relative to controls from weeks 3,5. In contrast, maximal pyloric sphincter (PS) circular smooth muscle contraction in response to KCl was significantly elevated in fish fed diet A in weeks 4 and 5. Serum osmolality was elevated in GDAS-affected fish from week 2 of the SW trial. Fluid transport from the mucosal to serosal surface of isolated pyloric caeca was significantly reduced in weeks 3, 4 and 5 in SW fish fed diet A. Gastric evacuation from the stomach of healthy fish was shown to be significantly different when diets of low- and high-cohesion were fed. The results are consistent with the intestinal brake playing a role in the development of the disease. [source] Epidemiology of irritable bowel syndrome in Asia: Something old, something new, something borrowedJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2009Kok-Ann Gwee Abstract In this review we have unearthed epidemiological data that; support the ,old' concept of irritable bowel syndrome (IBS) as a disorder of civilization, build a ,new' symptom profile of IBS for Asia, and persuade us against the use of ,borrowed' Western diagnostic criteria and illness models by Asian societies. In the 1960s, IBS was described as a disorder of civilization. Early studies from Asia suggested a prevalence of IBS below 5%. Recent studies from Asia suggest a trend for the more affluent city states like Singapore and Tokyo, to have higher prevalence of 8.6% and 9.8%, respectively, while India had the lowest prevalence of 4.2%. Furthermore, there was a trend among the better educated and more affluent strata of society in several urban Chinese populations for a higher prevalence of IBS, as well as a trend for a higher consultation rate. Across Chinese and Indian predominant populations, a majority of patients with IBS criteria report upper abdominal symptoms such as epigastric pain relieved by defecation, bloating and dyspepsia. Bloating and incomplete evacuation appear to be more important determinants of consultation behavior, than psychological factors. The failure of the Rome criteria to recognize the relationship to meals, may have led to a substantial misclassification of IBS as dyspepsia. The relevance of the Western model of psychological disturbance as a determinant of consultation behavior is questionable because of the accessibility and acceptability of medical consultation for gastrointestinal complaints in many Asian communities. [source] Developmental evaluation at age 4: Validity of an Italian parental questionnaireJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7-8 2010Anna Maria Dall'Oglio Aim: To validate an Italian parental questionnaire designed to evaluate the neuropsychological and behavioural developmental status of 4-year-olds and identify children in need of further evaluation. Methods: The questionnaire (Questionario per la valutazione dello Sviluppo di bambini a 4 anni , Genitori (QS4-G) ) consisted of 93 questions divided into 10 areas: language, visual-motor abilities, memory/attention, fine and gross motor and self-help abilities, lateralisation, social skills, stress, sleep, alimentation and evacuation. It was distributed to 263 parents of 4-year-olds: 94 healthy preterm (gestational age <33 weeks and/or <1500 g, without major neurosensory damage); 44 children with developmental disorders and 125 children with typical development. Cognitive and neuropsychological evaluations were performed using standardised tests. Results: The internal consistency of the areas was adequate (Cronbach's alpha: 0.69,0.79). The correlation coefficients (r=|0.30|,|0.68|) with standardised tests (Griffiths, Vineland and neuropsychological tests) indicated a good concurrent validity. The receiver operating characteristic curve, for predicting a Griffiths Quotient less than 81, showed an area under the curve of 0.90 and a high diagnostic and discriminatory capacity (sensitivity of 0.88 and specificity of 0.84) for the optimal cut-off (value 48.4). Conclusion: The QS4-G seems to be a valid tool for identifying 4-year-old children at risk for low or borderline cognitive development and/or problematic behaviour who need a complete assessment. It can describe individual neuropsychological profiles. QS4-G is not a diagnostic tool. It is useful for outcome studies in preterm children and in other pathologies. It could also be useful for preschooler prevention programmes. [source] Clinical trial: the efficacy and safety of routine bowel cleansing agents for elective colonoscopy in persons with spinal cord injury , a randomized prospective single-blind studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2009H. R. ANCHA Summary Background, As difficulty with evacuation is a common occurrence in individuals with spinal cord injury, preparation prior to colonoscopy may be suboptimal and, perhaps, more hazardous. Aim, To assess the safety and efficacy of bowel cleansing regimens in persons with spinal cord injury. Methods, Randomized, prospective, single blind study comparing polyethylene glycol (PEG), oral sodium phosphosoda (OSPS) and combination of both for colonic preparation prior to colonoscopy in subjects with spinal cord injury. Results, Thirty six subjects with eGFR ,60 mL/min/1.73 m2 were randomized to PEG or OSPS or PEG+OSPS. Regardless of bowel preparation employed, >73% of subjects had unacceptable colonic cleansing. No subject in the OSPS preparation group demonstrated a decrease in eGFR or an increase in serum creatinine concentration from the baseline. OSPS and PEG+OSPS preparations caused a transient change in serum potassium, phosphate and calcium concentrations, but no change in electrolytes was noted in the PEG group. Conclusions, Neither OSPS alone, PEG alone nor their combination was sufficient to prepare adequately the bowel for colonoscopy in most patients with spinal cord injury. However, administration of OSPS and/or PEG appears to be safe in the spinal cord injury population, provided adequate hydration is provided. [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] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||