51
|
Lampton LM. Katrina's lessons learned in Louisville. JOURNAL OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 2014; 55:206. [PMID: 25252422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
52
|
Ortega-Jimenez VM, Mittal R, Hedrick TL. Hawkmoth flight performance in tornado-like whirlwind vortices. BIOINSPIRATION & BIOMIMETICS 2014; 9:025003. [PMID: 24855051 DOI: 10.1088/1748-3182/9/2/025003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Vertical vortex systems such as tornadoes dramatically affect the flight control and stability of aircraft. However, the control implications of smaller scale vertically oriented vortex systems for small fliers such as animals or micro-air vehicles are unknown. Here we examined the flapping kinematics and body dynamics of hawkmoths performing hovering flights (controls) and maintaining position in three different whirlwind intensities with transverse horizontal velocities of 0.7, 0.9 and 1.2 m s(-1), respectively, generated in a vortex chamber. The average and standard deviation of yaw and pitch were respectively increased and reduced in comparison with hovering flights. Average roll orientation was unchanged in whirlwind flights but was more variable from wingbeat to wingbeat than in hovering. Flapping frequency remained unchanged. Wingbeat amplitude was lower and the average stroke plane angle was higher. Asymmetry was found in the angle of attack between right and left wings during both downstroke and upstroke at medium and high vortex intensities. Thus, hawkmoth flight control in tornado-like vortices is achieved by a suite of asymmetric and symmetric changes to wingbeat amplitude, stroke plane angle and principally angle of attack.
Collapse
|
53
|
Pulsipher GW, Hunter S. From ground zero to recovery: a hospital's devastating experience provides valuable lessons in hope and service. HEALTHCARE EXECUTIVE 2014; 29:62-65. [PMID: 24938008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
54
|
Olson C. Lessons learned in crisis management. JOURNAL OF BUSINESS CONTINUITY & EMERGENCY PLANNING 2014; 7:245-252. [PMID: 24578026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This paper will explore lessons learned following a series of natural and man-made disasters affecting the Massachusetts Mutual Life Insurance Company and/or its subsidiaries. The company employs a team of certified continuity professionals who are charged with overseeing resilience on behalf of the enterprise and leading recovery activities wherever and whenever necessary.
Collapse
|
55
|
Niederkrotenthaler T, Parker EM, Ovalle F, Noe RE, Bell J, Xu L, Morrison MA, Mertzlufft CE, Sugerman DE. Injuries and post-traumatic stress following historic tornados: Alabama, April 2011. PLoS One 2013; 8:e83038. [PMID: 24367581 PMCID: PMC3867464 DOI: 10.1371/journal.pone.0083038] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 10/30/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We analyzed tornado-related injuries seen at hospitals and risk factors for tornado injury, and screened for post-traumatic stress following a statewide tornado-emergency in Alabama in April 2011. METHODS We conducted a chart abstraction of 1,398 patients at 39 hospitals, mapped injured cases, and conducted a case-control telephone survey of 98 injured cases along with 200 uninjured controls. RESULTS Most (n = 1,111, 79.5%) injuries treated were non-life threatening (Injury Severity Score ≤ 15). Severe injuries often affected head (72.9%) and chest regions (86.4%). Mobile home residents showed the highest odds of injury (OR, 6.98; 95% CI: 2.10-23.20). No severe injuries occurred in tornado shelters. Within permanent homes, the odds of injury were decreased for basements (OR, 0.13; 95% CI: 0.04-0.40), bathrooms (OR, 0.22; 95% CI: 0.06-0.78), hallways (OR, 0.31; 95% CI: 0.11-0.90) and closets (OR, 0.25; 95% CI: 0.07-0.80). Exposure to warnings via the Internet (aOR, 0.20; 95% CI: 0.09-0.49), television (aOR, 0.45; 95% CI: 0.24-0.83), and sirens (aOR, 0.50; 95% CI: 0.30-0.85) decreased the odds of injury, and residents frequently exposed to tornado sirens had lower odds of injury. The prevalence of PTSD in respondents was 22.1% and screening positive for PTSD symptoms was associated with tornado-related loss events. CONCLUSIONS Primary prevention, particularly improved shelter access, and media warnings, seem essential to prevent severe tornado-injury. Small rooms such as bathrooms may provide some protection within permanent homes when no underground shelter is available.
Collapse
|
56
|
Hopkins K, Walley CF, Wilhelm D. Good planning pays off for PACE. HEALTH PROGRESS (SAINT LOUIS, MO.) 2013; 94:50-51. [PMID: 24308121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
57
|
Morrissey J. Embattled survivors give lifesaving advice. HEALTH PROGRESS (SAINT LOUIS, MO.) 2013; 94:12-19. [PMID: 24308116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
58
|
Fagan T. The generosity of dentists. JOURNAL - OKLAHOMA DENTAL ASSOCIATION 2013; 104:4-6. [PMID: 24279080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
59
|
Mathias JM. Surviving a disaster: nurses recall Moore's fierce tornado. OR MANAGER 2013; 29:5-12. [PMID: 24003625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
60
|
Kahler SC. Tornado takes toll on horses: Oklahoma response reflects preparedness. J Am Vet Med Assoc 2013; 243:181-182. [PMID: 23980311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
61
|
|
62
|
Martin D. Joplin tornado offers response lessons. HEALTH FACILITIES MANAGEMENT 2013; 26:48. [PMID: 23930433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
63
|
Carlson J. Seeking shelter. As tornado bore down, residents flocked to hospital. MODERN HEALTHCARE 2013; 43:14-15. [PMID: 23947097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
64
|
Conn J. Storm tests EHR. Medical records kept safe despite devastation. MODERN HEALTHCARE 2013; 43:14-15. [PMID: 23947098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
65
|
Danielson P. Workplace safety--emergency preparedness: would you know what to do? OHIO NURSES REVIEW 2013; 88:10-11. [PMID: 23798271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
66
|
Weber DO. After the storms. TRUSTEE : THE JOURNAL FOR HOSPITAL GOVERNING BOARDS 2013; 66:8-1. [PMID: 23777050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
At the center of their communities, hospitals are a safe haven and a foundation for rebuilding.
Collapse
|
67
|
|
68
|
|
69
|
Abstract
Three studies were designed to extend a combination of vested interest theory (VI) and the extended parallel process model of fear appeals (EPPM) to provide formative research for creating more effective disaster preparedness social action campaigns. The aim was to develop an effective VI scale for assessing individual awareness and 'vestedness' relevant to disaster preparedness. Typical preparedness behaviours are discussed with emphasis on earthquakes and tornados in particular. Brief overviews of VI and the EPPM are offered, and findings are presented from three studies (one dealing with earthquakes, and two with tornados) conducted to determine the factor structure of the key VI components involved, and to develop and test subscales derived from the two theories. The paper finishes with a discussion of future research needs and suggestions on how the new subscales may be applied in the design and execution of more effective disaster preparedness campaigns.
Collapse
|
70
|
Cluster of rare fungal infections identified after tornado. BMJ 2012; 345:e8382. [PMID: 23236038 DOI: 10.1136/bmj.e8382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
71
|
Neblett Fanfair R, Benedict K, Bos J, Bennett SD, Lo YC, Adebanjo T, Etienne K, Deak E, Derado G, Shieh WJ, Drew C, Zaki S, Sugerman D, Gade L, Thompson EH, Sutton DA, Engelthaler DM, Schupp JM, Brandt ME, Harris JR, Lockhart SR, Turabelidze G, Park BJ. Necrotizing cutaneous mucormycosis after a tornado in Joplin, Missouri, in 2011. N Engl J Med 2012; 367:2214-25. [PMID: 23215557 DOI: 10.1056/nejmoa1204781] [Citation(s) in RCA: 254] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mucormycosis is a fungal infection caused by environmentally acquired molds. We investigated a cluster of cases of cutaneous mucormycosis among persons injured during the May 22, 2011, tornado in Joplin, Missouri. METHODS We defined a case as a soft-tissue infection in a person injured during the tornado, with evidence of a mucormycete on culture or immunohistochemical testing plus DNA sequencing. We conducted a case-control study by reviewing medical records and conducting interviews with case patients and hospitalized controls. DNA sequencing and whole-genome sequencing were performed on clinical specimens to identify species and assess strain-level differences, respectively. RESULTS A total of 13 case patients were identified, 5 of whom (38%) died. The patients had a median of 5 wounds (range, 1 to 7); 11 patients (85%) had at least one fracture, 9 (69%) had blunt trauma, and 5 (38%) had penetrating trauma. All case patients had been located in the zone that sustained the most severe damage during the tornado. On multivariate analysis, infection was associated with penetrating trauma (adjusted odds ratio for case patients vs. controls, 8.8; 95% confidence interval [CI], 1.1 to 69.2) and an increased number of wounds (adjusted odds ratio, 2.0 for each additional wound; 95% CI, 1.2 to 3.2). Sequencing of the D1-D2 region of the 28S ribosomal DNA yielded Apophysomyces trapeziformis in all 13 case patients. Whole-genome sequencing showed that the apophysomyces isolates were four separate strains. CONCLUSIONS We report a cluster of cases of cutaneous mucormycosis among Joplin tornado survivors that were associated with substantial morbidity and mortality. Increased awareness of fungi as a cause of necrotizing soft-tissue infections after a natural disaster is warranted.
Collapse
|
72
|
Etienne KA, Gillece J, Hilsabeck R, Schupp JM, Colman R, Lockhart SR, Gade L, Thompson EH, Sutton DA, Neblett-Fanfair R, Park BJ, Turabelidze G, Keim P, Brandt ME, Deak E, Engelthaler DM. Whole genome sequence typing to investigate the Apophysomyces outbreak following a tornado in Joplin, Missouri, 2011. PLoS One 2012; 7:e49989. [PMID: 23209631 PMCID: PMC3507928 DOI: 10.1371/journal.pone.0049989] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 10/19/2012] [Indexed: 11/19/2022] Open
Abstract
Case reports of Apophysomyces spp. in immunocompetent hosts have been a result of traumatic deep implantation of Apophysomyces spp. spore-contaminated soil or debris. On May 22, 2011 a tornado occurred in Joplin, MO, leaving 13 tornado victims with Apophysomyces trapeziformis infections as a result of lacerations from airborne material. We used whole genome sequence typing (WGST) for high-resolution phylogenetic SNP analysis of 17 outbreak Apophysomyces isolates and five additional temporally and spatially diverse Apophysomyces control isolates (three A. trapeziformis and two A. variabilis isolates). Whole genome SNP phylogenetic analysis revealed three clusters of genotypically related or identical A. trapeziformis isolates and multiple distinct isolates among the Joplin group; this indicated multiple genotypes from a single or multiple sources. Though no linkage between genotype and location of exposure was observed, WGST analysis determined that the Joplin isolates were more closely related to each other than to the control isolates, suggesting local population structure. Additionally, species delineation based on WGST demonstrated the need to reassess currently accepted taxonomic classifications of phylogenetic species within the genus Apophysomyces.
Collapse
|
73
|
Woo I, Maciejewski R, Gaither KP, Ebert DS. Feature-driven data exploration for volumetric rendering. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2012; 18:1731-1743. [PMID: 22291153 DOI: 10.1109/tvcg.2012.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We have developed an intuitive method to semiautomatically explore volumetric data in a focus-region-guided or value-driven way using a user-defined ray through the 3D volume and contour lines in the region of interest. After selecting a point of interest from a 2D perspective, which defines a ray through the 3D volume, our method provides analytical tools to assist in narrowing the region of interest to a desired set of features. Feature layers are identified in a 1D scalar value profile with the ray and are used to define default rendering parameters, such as color and opacity mappings, and locate the center of the region of interest. Contour lines are generated based on the feature layer level sets within interactively selected slices of the focus region. Finally, we utilize feature-preserving filters and demonstrate the applicability of our scheme to noisy data.
Collapse
|
74
|
Tornado-related fatalities--five states, Southeastern United States, April 25-28, 2011. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2012; 61:529-533. [PMID: 22810266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
During April 25-28, 2011, a massive storm system generated 351 tornadoes (including 15 registering 4 or 5 on the Enhanced Fujita [EF] scale*), killing 338 persons in Alabama, Arkansas, Georgia, Mississippi, and Tennessee. This was the third-deadliest tornado event in the United States, surpassing an April 1974 event that resulted in 315 fatalities. This event also was historic because of the record number of fatalities that occurred despite modern advances in tornado forecasting, advanced warning times, and media coverage. Risk factors for death and injury from tornadoes are sheltering in mobile homes, proximity to an EF-4 or EF-5 tornado, being an older adult (aged ≥65 years), lack of accessibility to safe rooms (e.g., basements or reinforced shelters), and a night-time tornado impact. To describe the fatalities by demographic characteristics, type of shelter used, cause of death, and tornado severity and location, CDC reviewed data from the American Red Cross (Red Cross), death certificates, and the National Weather Service (NWS). This report summarizes the results of that review. Among the 338 decedents, median age was 55.0 years (range: 4 days-97 years); approximately one third were older adults. On tornado impact, 46.7% of decedents were in single-family homes, and 26.6% were in mobile homes. The leading cause of death was traumatic injury, including 21.9% with head injuries. Half of the deadly tornadoes were rated EF-4 or EF-5 and were responsible for 89.5% of the deaths. To prevent tornado-related deaths, health messaging should encourage the public (especially older adults and residents of mobile/manufactured homes) to pre-identify an accessible safe room, prepare the room with personal protection items (e.g., blankets and helmets), and monitor local weather.
Collapse
|
75
|
Hartmann EH, Creel N, Lepard J, Maxwell RA. Mass casualty following unprecedented tornadic events in the Southeast: natural disaster outcomes at a Level I trauma center. Am Surg 2012; 78:770-773. [PMID: 22748536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
On April 27, 2011, an EF4 (enhanced Fujita scale) tornado struck a 48-mile path across northwest Georgia and southeast Tennessee. Traumatic injuries sustained during this tornado and others in one of the largest tornado outbreaks in history presented to the regional Level I trauma center, Erlanger Health System, in Chattanooga, TN. Patients were triaged per mass casualty protocols through an incident command center and triage officer. Medical staffing was increased to anticipate a large patient load. Records of patients admitted as a result of tornado-related injury were retrospectively reviewed and characterized by the injury patterns, demographics, procedures performed, length of stay, and complications. One hundred four adult patients were treated in the emergency department; of these, 28 (27%) patients required admission to the trauma service. Of those admitted, 16 (57%) were male with an age range of 21 to 87 years old and an average length of stay of 10.9 ± 11.8 days. Eleven (39%) patients required intensive care unit admissions. The most common injuries seen were those of soft tissue, bony fractures, and the chest. Interventions included tube thoracostomies, exploratory laparotomies, orthopedic fixations, soft tissue reconstructions, and craniotomy. All 28 patients admitted survived to discharge. Nineteen (68%) patients were discharged home, six (21%) went to a rehabilitation hospital, and three (11%) were transferred to skilled nursing facilities. Emergency preparedness and organization are key elements in effectively treating victims of natural disasters. Those victims who survive the initial tornadic event and present to a Level I trauma center have low mortality. Like in our experience, triage protocols need to be implemented to quickly and effectively manage mass injuries.
Collapse
|